Texas Register February 7, 2025 Volume: 50 Number: 6

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Texas Health and Human Services Commission

Proposed Rules Re:

Amending 1 TAC §353.1415, to expand the minimum qualifications of Behavioral Health and Physical Services Network providers.

CHAPTER 353. MEDICAID MANAGED CARE
SUBCHAPTER P. MENTAL HEALTH TARGETED CASE MANAGEMENT AND MENTAL HEALTH REHABILITATION
1 TAC §353.1415

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §353.1415, concerning Staff Member Credentialing.

BACKGROUND AND PURPOSE

Texas Government Code §533.00255(d)(2) requires HHSC to ensure that providers in the Behavioral Health and Physical Services Network in §533.00255 are well-qualified and able to provide an appropriate array of services.

The proposed amendment expands the minimum qualifications for a Qualified Mental Health Professional-Community Services (QMHP-CS) credential to help address mental health workforce shortages.

Currently, the qualifications for a QMHP-CS credential include an option for individuals with a bachelor’s degree in a human services discipline to meet the criteria. The proposed amendment expands the list of acceptable human services degrees to include a bachelor’s degree in human development and family sciences, public health or child and family welfare.

In addition, the proposed amendment includes a new option for individuals with a non-human services bachelor’s degree to meet the criteria for a QMHP-CS credential if the individual has at least one year of documented experience as an intern or employee in a program that provides mental health or substance use services.

The proposed amendment to §353.1415 also updates rule formatting; updates a rule reference; and removes ambiguous language to align more closely with updates to the Texas Medicaid medical policies and state plan for Mental Health Targeted Case Management and Mental Health Rehabilitation Services.

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Amending 26 TAC §§357.101, 357.103, 357.105, 357.107, to update references to the United States Code and the Code of Federal Regulations; clarify minimum standards; and make non-substantive grammatical changes to improve wording and language.

CHAPTER 357. INDEPENDENT LIVING SERVICES PROGRAM
SUBCHAPTER A. GENERAL RULES
26 TAC §§357.101, 357.103, 357.105, 357.107

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §357.101, concerning Purpose; §357.103, concerning Legal Authority; §357.105, concerning Definitions; §357.201, concerning Allocation of Funds; §357.305, concerning Eligibility; §357.307, concerning Independent Living Plan; §357.309, concerning Waiting List; §357.311, concerning Scope of Services; §357.401, concerning Consumer Participation System; §357.403, concerning Fee Schedule Amount; §357.405, concerning Insurance Payments; §357.501, concerning Rights of Consumers; §357.503, concerning Complaint Process; §357.601, concerning Administering Agency’s Role in Providing Technical Assistance; and §357.701, concerning Expectations of Administering Agency’s Employees; and new §357.107, concerning Service Provider Standards and Contracts.

BACKGROUND AND PURPOSE

The purpose of the proposal is to update references in rule to reflect changes made due to the implementation of Senate Bill (S.B.) 200, 84th Legislature, Regular Session, 2015, which required the dissolution of the Department of Assistive and Rehabilitative Services (DARS). Independent Living Services (ILS) transferred to HHSC from the legacy DARS as part of the Health and Human Services Transformation. The program was subsequently outsourced to the Centers for Independent Living (CIL) on September 1, 2016, as required by House Bill (H.B.) 2463, 84th Legislature, Regular Session, 2015. HHSC continues to oversee ILS, except for Independent Living Services for Older Individuals who are Blind, which transferred to the Texas Workforce Commission as required by S.B. 208, 84th Legislature, Regular Session, 2015.

The proposal updates references from DARS to HHSC, outdated terms such as “individual” or “consumer,” and references to “person” or “people” to align with the agency’s person-centered language policy. A new rule requires service providers to adhere to the service provider standards and clarifies that they are responsible for any subcontracted services. The proposal changes eligibility criteria to require a person to reside in Texas, instead of merely being present in Texas.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §357.101 makes non-substantive grammatical changes to improve wording.

The proposed amendment to §357.103 updates references to the United States Code (USC) and the Code of Federal Regulations (CFR). 29 USC 711(c) is removed. 34 CFR Parts 364, 365, and 366 have been removed and replaced by 45 CFR, Part 1329. The paragraphs are rearranged for easier readability.

The proposed amendment to §357.105 updates person-centered language, updates references to DARS, removes definitions that are no longer applicable, and adds new definitions for “consumer participation agreement,” “HHSC,” “Independent Living Services Program,” “person,” “representative,” “support services,” “vendor,” and “youth with a disability.”

Proposed new §357.107 requires a service provider to adhere to the service provider standards and clarifies that the service provider is responsible for any subcontracted services.

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Amending 26 TAC §357.201, to make non-substantive wording changes.

CHAPTER 357. INDEPENDENT LIVING SERVICES PROGRAM
SUBCHAPTER B. ALLOCATION OF FUNDS
26 TAC §357.201

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §357.101, concerning Purpose; §357.103, concerning Legal Authority; §357.105, concerning Definitions; §357.201, concerning Allocation of Funds; §357.305, concerning Eligibility; §357.307, concerning Independent Living Plan; §357.309, concerning Waiting List; §357.311, concerning Scope of Services; §357.401, concerning Consumer Participation System; §357.403, concerning Fee Schedule Amount; §357.405, concerning Insurance Payments; §357.501, concerning Rights of Consumers; §357.503, concerning Complaint Process; §357.601, concerning Administering Agency’s Role in Providing Technical Assistance; and §357.701, concerning Expectations of Administering Agency’s Employees; and new §357.107, concerning Service Provider Standards and Contracts.

BACKGROUND AND PURPOSE

The purpose of the proposal is to update references in rule to reflect changes made due to the implementation of Senate Bill (S.B.) 200, 84th Legislature, Regular Session, 2015, which required the dissolution of the Department of Assistive and Rehabilitative Services (DARS). Independent Living Services (ILS) transferred to HHSC from the legacy DARS as part of the Health and Human Services Transformation. The program was subsequently outsourced to the Centers for Independent Living (CIL) on September 1, 2016, as required by House Bill (H.B.) 2463, 84th Legislature, Regular Session, 2015. HHSC continues to oversee ILS, except for Independent Living Services for Older Individuals who are Blind, which transferred to the Texas Workforce Commission as required by S.B. 208, 84th Legislature, Regular Session, 2015.

The proposal updates references from DARS to HHSC, outdated terms such as “individual” or “consumer,” and references to “person” or “people” to align with the agency’s person-centered language policy. A new rule requires service providers to adhere to the service provider standards and clarifies that they are responsible for any subcontracted services. The proposal changes eligibility criteria to require a person to reside in Texas, instead of merely being present in Texas.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §357.201 updates references to DARS and makes other non-substantive wording changes.

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Amending 26 TAC §§357.305, 357.307, 357.309, 357.311, to update outdated citations, correct old language, and remove personal assistance and supported living from independent living services.

CHAPTER 357. INDEPENDENT LIVING SERVICES PROGRAM
SUBCHAPTER C. INDEPENDENT LIVING SERVICES
26 TAC §§357.305, 357.307, 357.309, 357.311

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §357.101, concerning Purpose; §357.103, concerning Legal Authority; §357.105, concerning Definitions; §357.201, concerning Allocation of Funds; §357.305, concerning Eligibility; §357.307, concerning Independent Living Plan; §357.309, concerning Waiting List; §357.311, concerning Scope of Services; §357.401, concerning Consumer Participation System; §357.403, concerning Fee Schedule Amount; §357.405, concerning Insurance Payments; §357.501, concerning Rights of Consumers; §357.503, concerning Complaint Process; §357.601, concerning Administering Agency’s Role in Providing Technical Assistance; and §357.701, concerning Expectations of Administering Agency’s Employees; and new §357.107, concerning Service Provider Standards and Contracts.

BACKGROUND AND PURPOSE

The purpose of the proposal is to update references in rule to reflect changes made due to the implementation of Senate Bill (S.B.) 200, 84th Legislature, Regular Session, 2015, which required the dissolution of the Department of Assistive and Rehabilitative Services (DARS). Independent Living Services (ILS) transferred to HHSC from the legacy DARS as part of the Health and Human Services Transformation. The program was subsequently outsourced to the Centers for Independent Living (CIL) on September 1, 2016, as required by House Bill (H.B.) 2463, 84th Legislature, Regular Session, 2015. HHSC continues to oversee ILS, except for Independent Living Services for Older Individuals who are Blind, which transferred to the Texas Workforce Commission as required by S.B. 208, 84th Legislature, Regular Session, 2015.

The proposal updates references from DARS to HHSC, outdated terms such as “individual” or “consumer,” and references to “person” or “people” to align with the agency’s person-centered language policy. A new rule requires service providers to adhere to the service provider standards and clarifies that they are responsible for any subcontracted services. The proposal changes eligibility criteria to require a person to reside in Texas, instead of merely being present in Texas.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §357.305 updates the citations from the previous location in Title 40, Texas Administrative Code, §104.105, changes the eligibility requirements from being present in Texas to residing in Texas, removes the statement that anyone determined eligible by DARS remains eligible with HHSC, and updates language regarding protections afforded to applicants when eligibility requirements are applied.

The proposed amendment to §357.307 updates text to person-centered language; corrects outdated citations; and includes other community, state, and federal programs that are necessary to the coordination of services.

The proposed amendment to §357.309 updates text to person-centered language and updates a citation.

The proposed amendment to §357.311 removes personal assistance and supported living as independent living services, updates text to person-centered language, and corrects outdated citations.

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Amending 26 TAC §§357.401, 357.403, 357.405, to update references to DARS, improve wording to be more person-centered, prohibit the collection of consumer participation for support services, and make other non-substantive wording changes.

CHAPTER 357. INDEPENDENT LIVING SERVICES PROGRAM
SUBCHAPTER D. CONSUMER PARTICIPATION
26 TAC §§357.401, 357.403, 357.405

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §357.101, concerning Purpose; §357.103, concerning Legal Authority; §357.105, concerning Definitions; §357.201, concerning Allocation of Funds; §357.305, concerning Eligibility; §357.307, concerning Independent Living Plan; §357.309, concerning Waiting List; §357.311, concerning Scope of Services; §357.401, concerning Consumer Participation System; §357.403, concerning Fee Schedule Amount; §357.405, concerning Insurance Payments; §357.501, concerning Rights of Consumers; §357.503, concerning Complaint Process; §357.601, concerning Administering Agency’s Role in Providing Technical Assistance; and §357.701, concerning Expectations of Administering Agency’s Employees; and new §357.107, concerning Service Provider Standards and Contracts.

BACKGROUND AND PURPOSE

The purpose of the proposal is to update references in rule to reflect changes made due to the implementation of Senate Bill (S.B.) 200, 84th Legislature, Regular Session, 2015, which required the dissolution of the Department of Assistive and Rehabilitative Services (DARS). Independent Living Services (ILS) transferred to HHSC from the legacy DARS as part of the Health and Human Services Transformation. The program was subsequently outsourced to the Centers for Independent Living (CIL) on September 1, 2016, as required by House Bill (H.B.) 2463, 84th Legislature, Regular Session, 2015. HHSC continues to oversee ILS, except for Independent Living Services for Older Individuals who are Blind, which transferred to the Texas Workforce Commission as required by S.B. 208, 84th Legislature, Regular Session, 2015.

The proposal updates references from DARS to HHSC, outdated terms such as “individual” or “consumer,” and references to “person” or “people” to align with the agency’s person-centered language policy. A new rule requires service providers to adhere to the service provider standards and clarifies that they are responsible for any subcontracted services. The proposal changes eligibility criteria to require a person to reside in Texas, instead of merely being present in Texas.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §357.401 adds language prohibiting the collection of consumer participation for support services, updates text to person-centered language, updates references to DARS, and corrects outdated citations.

The proposed amendment to §357.403 updates references to DARS, updates text to person-centered language, and makes non-substantive wording changes.

The proposed amendment to §357.405 simplifies the insurance wording, adds person-centered language, and updates references to DARS.

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Amending 26 TAC §357.501, §357.503, to change the title to “Personal Rights,” incorporate person-centered language, update language prohibiting discrimination by HHSC, and update references to DARS.

CHAPTER 357. INDEPENDENT LIVING SERVICES PROGRAM
SUBCHAPTER E. PERSONAL [CONSUMER] RIGHTS
26 TAC §357.501, §357.503

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §357.101, concerning Purpose; §357.103, concerning Legal Authority; §357.105, concerning Definitions; §357.201, concerning Allocation of Funds; §357.305, concerning Eligibility; §357.307, concerning Independent Living Plan; §357.309, concerning Waiting List; §357.311, concerning Scope of Services; §357.401, concerning Consumer Participation System; §357.403, concerning Fee Schedule Amount; §357.405, concerning Insurance Payments; §357.501, concerning Rights of Consumers; §357.503, concerning Complaint Process; §357.601, concerning Administering Agency’s Role in Providing Technical Assistance; and §357.701, concerning Expectations of Administering Agency’s Employees; and new §357.107, concerning Service Provider Standards and Contracts.

BACKGROUND AND PURPOSE

The purpose of the proposal is to update references in rule to reflect changes made due to the implementation of Senate Bill (S.B.) 200, 84th Legislature, Regular Session, 2015, which required the dissolution of the Department of Assistive and Rehabilitative Services (DARS). Independent Living Services (ILS) transferred to HHSC from the legacy DARS as part of the Health and Human Services Transformation. The program was subsequently outsourced to the Centers for Independent Living (CIL) on September 1, 2016, as required by House Bill (H.B.) 2463, 84th Legislature, Regular Session, 2015. HHSC continues to oversee ILS, except for Independent Living Services for Older Individuals who are Blind, which transferred to the Texas Workforce Commission as required by S.B. 208, 84th Legislature, Regular Session, 2015.

The proposal updates references from DARS to HHSC, outdated terms such as “individual” or “consumer,” and references to “person” or “people” to align with the agency’s person-centered language policy. A new rule requires service providers to adhere to the service provider standards and clarifies that they are responsible for any subcontracted services. The proposal changes eligibility criteria to require a person to reside in Texas, instead of merely being present in Texas.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §357.501 changes the title from “Rights of Consumers” to “Personal Rights,” uses person-centered language, updates language prohibiting discrimination by HHSC, and updates references to DARS.

The proposed amendment to §357.503 updates the HHSC Ombudsman’s office online contact information, updates references to DARS, and uses person-centered language.

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Amending 26 TAC §357.601, to change the title to “Technical Assistance Provided by HHSC” and update references to DARS.

CHAPTER 357. INDEPENDENT LIVING SERVICES PROGRAM
SUBCHAPTER F. TECHNICAL ASSISTANCE AND TRAINING
26 TAC §357.601

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §357.101, concerning Purpose; §357.103, concerning Legal Authority; §357.105, concerning Definitions; §357.201, concerning Allocation of Funds; §357.305, concerning Eligibility; §357.307, concerning Independent Living Plan; §357.309, concerning Waiting List; §357.311, concerning Scope of Services; §357.401, concerning Consumer Participation System; §357.403, concerning Fee Schedule Amount; §357.405, concerning Insurance Payments; §357.501, concerning Rights of Consumers; §357.503, concerning Complaint Process; §357.601, concerning Administering Agency’s Role in Providing Technical Assistance; and §357.701, concerning Expectations of Administering Agency’s Employees; and new §357.107, concerning Service Provider Standards and Contracts.

BACKGROUND AND PURPOSE

The purpose of the proposal is to update references in rule to reflect changes made due to the implementation of Senate Bill (S.B.) 200, 84th Legislature, Regular Session, 2015, which required the dissolution of the Department of Assistive and Rehabilitative Services (DARS). Independent Living Services (ILS) transferred to HHSC from the legacy DARS as part of the Health and Human Services Transformation. The program was subsequently outsourced to the Centers for Independent Living (CIL) on September 1, 2016, as required by House Bill (H.B.) 2463, 84th Legislature, Regular Session, 2015. HHSC continues to oversee ILS, except for Independent Living Services for Older Individuals who are Blind, which transferred to the Texas Workforce Commission as required by S.B. 208, 84th Legislature, Regular Session, 2015.

The proposal updates references from DARS to HHSC, outdated terms such as “individual” or “consumer,” and references to “person” or “people” to align with the agency’s person-centered language policy. A new rule requires service providers to adhere to the service provider standards and clarifies that they are responsible for any subcontracted services. The proposal changes eligibility criteria to require a person to reside in Texas, instead of merely being present in Texas.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §357.601 changes the title from “Administering Agency’s Role in Providing Technical Assistance” to “Technical Assistance Provided by HHSC” and updates references to DARS.

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Amending 26 TAC §357.701, to change the title to “Referrals Received by HHSC,” add person-centered language, update references to DARS, and update accessibility to the contact information of the Independent Living Services provider.

CHAPTER 357. INDEPENDENT LIVING SERVICES PROGRAM
SUBCHAPTER G. REFERRALS
26 TAC §357.701

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §357.101, concerning Purpose; §357.103, concerning Legal Authority; §357.105, concerning Definitions; §357.201, concerning Allocation of Funds; §357.305, concerning Eligibility; §357.307, concerning Independent Living Plan; §357.309, concerning Waiting List; §357.311, concerning Scope of Services; §357.401, concerning Consumer Participation System; §357.403, concerning Fee Schedule Amount; §357.405, concerning Insurance Payments; §357.501, concerning Rights of Consumers; §357.503, concerning Complaint Process; §357.601, concerning Administering Agency’s Role in Providing Technical Assistance; and §357.701, concerning Expectations of Administering Agency’s Employees; and new §357.107, concerning Service Provider Standards and Contracts.

BACKGROUND AND PURPOSE

The purpose of the proposal is to update references in rule to reflect changes made due to the implementation of Senate Bill (S.B.) 200, 84th Legislature, Regular Session, 2015, which required the dissolution of the Department of Assistive and Rehabilitative Services (DARS). Independent Living Services (ILS) transferred to HHSC from the legacy DARS as part of the Health and Human Services Transformation. The program was subsequently outsourced to the Centers for Independent Living (CIL) on September 1, 2016, as required by House Bill (H.B.) 2463, 84th Legislature, Regular Session, 2015. HHSC continues to oversee ILS, except for Independent Living Services for Older Individuals who are Blind, which transferred to the Texas Workforce Commission as required by S.B. 208, 84th Legislature, Regular Session, 2015.

The proposal updates references from DARS to HHSC, outdated terms such as “individual” or “consumer,” and references to “person” or “people” to align with the agency’s person-centered language policy. A new rule requires service providers to adhere to the service provider standards and clarifies that they are responsible for any subcontracted services. The proposal changes eligibility criteria to require a person to reside in Texas, instead of merely being present in Texas.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §357.701 changes the title from “Expectations of Administering Agency’s Employees” to “Referrals Received by HHSC,” uses person-centered language, updates references to DARS, and updates how a person can find contact information for the Independent Living Services provider.

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Adopted Rules Re:

Adopting 26 TAC §350.101, to develop and implement a system that provides early childhood intervention services for infants and toddlers with disabilities and their families.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER A. GENERAL RULES
26 TAC §350.101

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §350.101, to repeal the following chapter to update and restructure the rules in accordance with legislative updates.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER A. GENERAL RULES
26 TAC §350.101

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §350.103, §350.107, to update the definitions of terms used in the chapter and set forth contractor compliance with policies and procedures related to

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER A. GENERAL RULES
26 TAC §350.103, §350.107

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §350.201, to describe the general requirements for procedural safeguards as related to early childhood intervention services.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER B. PROCEDURAL SAFEGUARDS AND DUE PROCESS PROCEDURES
26 TAC §350.201

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §350.209, §350.225, to set forth parents rights in the Individualized Family Service Plan (IFSP) process.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER B. PROCEDURAL SAFEGUARDS AND DUE PROCESS PROCEDURES
26 TAC §350.209, §350.225

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §350.301, to repeal the following chapter to update and restructure the rules in accordance with legislative updates.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER C. STAFF QUALIFICATIONS
26 TAC §350.301

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §§350.303, 350.309, 350.312, 350.313, 350.315, to define the terms used in the chapter, minimum requirements for all direct service staff, and requirements to satisfy Licensed Practitioner of the Healing Arts (LPHA), Early Intervention Specialist (EIS), and Service Coordinator licensing standards.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER C. STAFF QUALIFICATIONS
26 TAC §§350.303, 350.309, 350.312, 350.313, 350.315

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §§350.403 – 350.407, 350.411, 350.415, to define the case management process for infants and toddlers with developmental disabilities.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER D. CASE MANAGEMENT FOR INFANTS AND TODDLERS WITH DEVELOPMENTAL DISABILITIES
26 TAC §§350.403 – 350.407, 350.411, 350.415

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §350.501, §350.507, to define specialized rehabilitative services and due process for recipients or providers whose services are denied or not acted upon, and whose specialized rehabilitative services have been terminated, suspended, or reduced.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER E. SPECIALIZED REHABILITATIVE SERVICES
26 TAC §350.501, §350.507

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §350.601, to repeal the following chapter to update and restructure the rules in accordance with legislative updates.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER F. PUBLIC OUTREACH
26 TAC §350.601

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, 350.617, to define terms used in the chapter and public outreach as related to early childhood intervention services.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER F. PUBLIC OUTREACH
26 TAC §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, 350.617

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §350.701, to repeal the following chapter to update and restructure the rules in accordance with legislative updates.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER G. REFERRAL, PRE-ENROLLMENT, AND DEVELOPMENTAL SCREENING
26 TAC §350.701

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §§350.704, 350.706 – 350.709, to set forth the referral, pre-enrollment, and developmental screening processes used by early childhood intervention services.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER G. REFERRAL, PRE-ENROLLMENT, AND DEVELOPMENTAL SCREENING
26 TAC §§350.704, 350.706 – 350.709

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

---

Adopting 26 TAC §350.801, to repeal the following chapter to update and restructure the rules in accordance with legislative updates.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER H. ELIGIBILITY, EVALUATION, AND ASSESSMENT
26 TAC §350.801

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

---

Adopting 26 TAC §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, 350.837, to set out the eligibility, evaluation, and assessment of children with potential developmental delays.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER H. ELIGIBILITY, EVALUATION, AND ASSESSMENT
26 TAC §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, 350.837

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

---

Adopting 26 TAC §350.1001, to repeal the following chapter to update and restructure the rules in accordance with legislative updates.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER J. INDIVIDUALIZED FAMILY SERVICE PLAN (IFSP)
26 TAC §350.1001

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, 350.1019, to set forth the individualized family service plan (IFSP).

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
26 TAC §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, 350.1019

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §350.1101, to repeal the following chapter to update and restructure the rules in accordance with legislative updates.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER K. SERVICE DELIVERY
26 TAC §350.1101

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §§350.1104, 350.1108, 350.1111, to outline early childhood intervention services delivery; state funded respite services, and service delivery documentation requirements.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER K. SERVICE DELIVERY
26 TAC §§350.1104, 350.1108, 350.1111

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §350.1201, to repeal the following chapter to update and restructure the rules in accordance with legislative updates.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER L. TRANSITION
26 TAC §350.1201

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, 350.1221, to set forth the transition process and other services that facilitate the process.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER L. TRANSITION
26 TAC §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, 350.1221

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §350.1301, to repeal the following chapter to update and restructure the rules in accordance with legislative updates.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER M. CHILD AND FAMILY OUTCOMES
26 TAC §350.1301

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §350.1307, §350.1309, to set forth the purpose and measurements to determine outcomes for children and families.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER M. CHILD AND FAMILY OUTCOMES
26 TAC §350.1307, §350.1309

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §350.1401, to repeal the following chapter to update and restructure the rules in accordance with legislative updates.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER N. FAMILY COST SHARE SYSTEM
26 TAC §350.1401

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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Adopting 26 TAC §§350.1405, 350.1411, 350.1413, 350.1431, 350.1433, to set forth the family cost share system and its general administration.

CHAPTER 350. EARLY CHILDHOOD INTERVENTION SERVICES
SUBCHAPTER N. FAMILY COST SHARE SYSTEM
26 TAC §§350.1405, 350.1411, 350.1413, 350.1431, 350.1433

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to the Texas Administrative Code (TAC), Title 26, Chapter 350, Subchapter A, concerning General Rules, §350.103 and §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, and 350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501 and §350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.813, 350.815, 350.817, 350.821, 350.823, 350.825, 350.829, 350.833, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1009, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1413, 350.1431, and 350.1433.

HHSC also adopts the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401.

The amendments to Subchapter A, concerning General Rules, §350.103; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.813, §350.815 and §350.833; Subchapter J, concerning Individualized Family Service Plan, §350.1009; and Subchapter N, concerning Family Cost Share, §350.1413, are adopted with changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will be republished.

The amendments to Subchapter A, concerning General Rules, §350.107; Subchapter B, concerning Procedural Safeguards and Due Process Procedures, §350.209 and §350.225; Subchapter C, concerning Staff Qualifications, §§350.303, 350.309, 350.312, 350.313, and 350.315; Subchapter D, concerning Case Management for Infants and Toddlers with Developmental Disabilities, §§350.403, 350.404, 350.405, 350.406, 350.407, 350.411, §350.415; Subchapter E, concerning Specialized Rehabilitative Services, §350.501, and 350.507; Subchapter F, concerning Public Outreach, §§350.605, 350.607, 350.609, 350.611, 350.613, 350.615, and 350.617; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §§350.704, 350.706, 350.707, 350.708, and 350.709; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §§350.805, 350.807, 350.809, 350.811, 350.817, 350.821, 350.823, 350.825, 350.829, 350.835, and 350.837; Subchapter J, concerning Individualized Family Service Plan, §§350.1003, 350.1004, 350.1007, 350.1015, 350.1017, and 350.1019; Subchapter K, concerning Service Delivery, §§350.1104, 350.1108, and 350.1111; Subchapter L, concerning Transition, §§350.1203, 350.1207, 350.1209, 350.1211, 350.1213, 350.1215, 350.1217, 350.1219, and 350.1221; Subchapter M, concerning Child and Family Outcomes, §350.1307 and §350.1309; and Subchapter N, concerning Family Cost Share System, §§350.1405, 350.1411, 350.1431, and 350.1433; and the repeal of 26 TAC Subchapter A, concerning General Rules, §350.101; Subchapter B, concerning Procedural Safeguards and Due Process Procedures; §350.201; Subchapter C, concerning Staff Qualifications; §350.301; Subchapter F, concerning Public Outreach, §350.601; Subchapter G, concerning Referral, Pre-Enrollment, and Developmental Screening, §350.701; Subchapter H, concerning Eligibility, Evaluation, and Assessment, §350.801; Subchapter J, concerning Individualized Family Service Plan; §350.1001, Subchapter K, concerning Service Delivery, §350.1101; Subchapter L, concerning Transition, §350.1201, Subchapter M, concerning Child and Family Outcomes, §350.1301; and Subchapter N, concerning Family Cost Share System, §350.1401 are adopted without changes to the proposed text as published in the September 13, 2024, issue of the Texas Register (49 TexReg 7237). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption amends rules as they relate to Early Childhood Intervention (ECI) to align policy with legislation, increase administrative efficiencies, and improve processes for ECI subrecipients. The amendments also include non-substantive changes to improve readability, consistency, and understanding, and to align language with HHSC rulemaking standards.

As required by Texas Government Code Section 2001.039, ECI completed a four-year rule review to determine whether the rule was necessary or if the purpose of creating the rule no longer applied. All repealed rules are the result of the four-year review. The amendment to §350.107 aligns ECI policy with legislation enacted by House Bill 44, 88th Texas Legislature, Regular Session, 2023.

In July 2024, the Texas Education Agency (TEA) amended rules in 19 TAC §89.1040 related to eligibility for children who are deaf, hard of hearing, or have a visual impairment. Because HHSC ECI had already opened rules in 26 TAC Chapter 350, before the TEA rules were enacted, these amendments were not reflected in the proposal rule packet. Due to references in ECI rule to the TEA eligibility requirements, it is necessary to make these amendments now to remove language from the ECI rules that contradicts the amended TEA rules. To align ECI and TEA eligibility requirements, necessary amendments have been made to §350.813 and §350.815 that were not directly in response to formal public comments. The necessary amendments were made through ongoing collaboration with ECI subrecipients, stakeholders, and representatives of TEA.

Remaining amendments are to address input from ECI subrecipients, stakeholders, and HHSC ECI staff to improve clarity, reduce barriers, and make necessary corrections. The amended and repealed rules address several areas including minimum staff qualifications, programmatic requirements, and additional needs identified through ongoing collaboration with ECI subrecipients and stakeholders.

There is no fiscal impact to state government from implementation of the proposed rules. All changes are to provide clarity and align rules with contract and federal requirements, or to allow administrative efficiencies for ECI subrecipients.

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In Addition Re:

Notice of Public Hearing on Proposed Rule Amendments for Reimbursement Methodology for Physician and Other Practitioners, and Reimbursement Methodologies for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Services

Hearing. The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on February 24, 2025, at 9:00 a.m., to receive public comments on proposed rule amendments to 1 Texas Administrative Code (TAC) §355.8085, Reimbursement Methodology for Physicians and Other Practitioners; and §355.8441, Reimbursement Methodologies for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Services (also known as Texas Health Steps).

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Texas Department of State Health Services

Adopted Rules Re:

Adopting 25 TAC §1.151, §1.152, to repeal the definitions, purpose, appointment, and terms sections.

CHAPTER 1. MISCELLANEOUS PROVISIONS
SUBCHAPTER L. MEDICAL ADVISORY BOARD
25 TAC §1.151, §1.152

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts the repeal of §1.151, concerning Definitions, and §1.152, concerning Operation of the Medical Advisory Board (MAB); and new §1.151, concerning Definitions, and §1.152, concerning Operation of the Medical Advisory Board (MAB).

The repeal of and new §1.151 and §1.152 are adopted without changes to the proposed text as published in the November 1, 2024, issue of the Texas Register (49 TexReg 8672). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption updates the definitions, content, and processes of the Medical Advisory Board (MAB) and clarifies compensation for MAB members. The repeal of and new §1.151 and §1.152 comply with changes to Texas Health and Safety Code §§12.091 – 12.098, Texas Transportation Code §521.294, and 37 Texas Administrative Code §15.58; and reflect updates to MAB membership, operations, requirements, medical packet contents, and confidentiality provisions.

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Adopting 25 TAC §1.151, §1.152, to update definitions and define the operation of the MAB and its requirements to improve clarity, consistency, and style.

CHAPTER 1. MISCELLANEOUS PROVISIONS
SUBCHAPTER L. MEDICAL ADVISORY BOARD
25 TAC §1.151, §1.152

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts the repeal of §1.151, concerning Definitions, and §1.152, concerning Operation of the Medical Advisory Board (MAB); and new §1.151, concerning Definitions, and §1.152, concerning Operation of the Medical Advisory Board (MAB).

The repeal of and new §1.151 and §1.152 are adopted without changes to the proposed text as published in the November 1, 2024, issue of the Texas Register (49 TexReg 8672). These rules will not be republished.

BACKGROUND AND PURPOSE

The adoption updates the definitions, content, and processes of the Medical Advisory Board (MAB) and clarifies compensation for MAB members. The repeal of and new §1.151 and §1.152 comply with changes to Texas Health and Safety Code §§12.091 – 12.098, Texas Transportation Code §521.294, and 37 Texas Administrative Code §15.58; and reflect updates to MAB membership, operations, requirements, medical packet contents, and confidentiality provisions.

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Adopting 25 TAC §37.401, to rename the rule to Maternal Mortality and Morbidity Review Committee (MMMRC), increase the number of voting members appointed by the DSHS Commissioner, change the MMMRC membership terms, add training requirements, and change the abolishment and expiration date of the MMMRC to September 1, 2027.

CHAPTER 37. MATERNAL AND INFANT HEALTH SERVICES
SUBCHAPTER R. ADVISORY COMMITTEES
25 TAC §37.401

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts an amendment to §37.401, concerning Maternal Mortality and Morbidity Review Committee. The amendment to §37.401 is adopted without changes to the proposed text as published in the October 25, 2024, issue of the Texas Register (49 TexReg 8524), and therefore will not be republished.

BACKGROUND AND PURPOSE

The amendment is necessary to comply with Texas Health and Safety Code, Chapter 34, amended by House Bill (H.B.) 852, 88th Legislature, Regular session, 2023, which added six new Maternal Mortality and Morbidity Review Committee (MMMRC) members and amended the current community advocate MMMRC member position. New positions include physicians specializing in emergency care, cardiology, anesthesiology, oncology, and a representative of a managed care organization. Additionally, the former community advocate position was changed to two community members with experience in a relevant health care field involving the analysis of health care data. One of the community members must represent an urban area of this state, and another must represent a rural area.

H.B. 852 also staggered membership terms, making one-third of the terms expire on every odd-numbered year.

Furthermore, the amendment requires changing the title of §37.401 from Maternal Mortality and Morbidity Task Force to Maternal Mortality and Morbidity Review Committee.

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Adopting 25 TAC §157.11, to revise language for clarity, consistency, and style; update reference to current laws; and clarify participation in the Regional Advisory Council to align with current practices in the United States.

CHAPTER 157. EMERGENCY MEDICAL CARE
SUBCHAPTER B. EMERGENCY MEDICAL SERVICES PROVIDER LICENSES
25 TAC §157.11

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts an amendment to §157.11, concerning Requirements for an Emergency Medical Services (EMS) Provider License.

The amendment to §157.11 is adopted without changes to the proposed text as published in the October 25, 2024, issue of the Texas Register (49 TexReg 8528), and therefore will not be republished.

BACKGROUND AND PURPOSE

The amendment is necessary to comply with Senate Bill (S.B.) 2133, 88th Legislature, Regular Session, 2023, that amended Texas Health and Safety Code (HSC) §773.050 by adding subsection (j). The new subsection requires emergency medical services (EMS) providers to have a plan for transporting dialysis patients directly to and from an outpatient end stage renal disease facility during a declared disaster if the patient’s normal and alternative modes of transportation cannot be used. Texas HSC §773.050(j) permits the EMS provider’s plan to prioritize transporting a patient suffering from an acute emergency condition over transporting a dialysis patient. The amendment to 25 TAC §157.11 aligns with the changes in Texas HSC §773.050.

Additionally, House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. The amendment is necessary to update a citation in the rule to Texas Government Code that becomes effective on April 1, 2025.

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