Governor
Appointments Re:
Appointments for July 14, 2026
Appointed to the Texas Opioid Abatement Fund Council for a term to expire February 1, 2031, Yasser F. Zeid, M.D. of Tyler, Texas (replacing John G. Mills, D.O. of Port Bolivar who resigned).
Appointments for July 15, 2026
Appointed as the director of the Task Force of Infectious Disease Preparedness and Response for a term to expire at the pleasure of the Governor, Maria I. “Imelda” Garcia of Austin, Texas (replacing Jennifer A. Shuford, M.D. of West Lake Hills).
Appointed to the Task Force on Infectious Disease Preparedness and Response for a term to expire at the pleasure of the Governor, Maria I. “Imelda” Garcia of Austin, Texas (replacing Jennifer A. Shuford, M.D. of West Lake Hills).
Texas Board of Chiropractic Examiners
Proposed Rules Re:
Amending 22 TAC §72.1, to correct a numbering error in the Board’s fee schedule.
CHAPTER 72. BOARD FEES, LICENSE APPLICATIONS, AND RENEWALS
22 TAC §72.1
OVERVIEW
The Texas Board of Chiropractic Examiners (Board) proposes an amendment to 22 TAC §72.1 (Fees). This rulemaking action will correct a numbering error in the current rule. As it currently reads, 22 TAC §72.1 jumps from 22 TAC §72.1(14) to §72.1(16), excluding the number 15. In turn, this error causes all subsequent numbers to be incorrect. This amendment corrects that numbering error so that all provisions in this section are numbered correctly.
Amending 22 TAC §72.3, to correct the names of two chiropractic education accreditation organizations.
CHAPTER 72. BOARD FEES, LICENSE APPLICATIONS, AND RENEWALS
22 TAC §72.3
OVERVIEW
The Texas Board of Chiropractic Examiners (Board) proposes an amendment to 22 TAC §72.3 (Qualifications). This rulemaking action will correct the names of two education accreditation organizations in the current rule. The rule currently identifies the Councils on Chiropractic International and Council on Chiropractic Education International. These names are incorrect. They should ready Council on Chiropractic Education and Councils on Chiropractic Education International.
Amending 22 TAC §75.5, to expand permitted financial arrangements for chiropractic services and require disclosure and no-penalty cancellation rights for patients.
CHAPTER 75. BUSINESS PRACTICES
22 TAC §75.5
OVERVIEW
The Texas Board of Chiropractic Examiners (Board) proposes amendments to 22 TAC §75.5 (Prepaid Treatment Plans). This rulemaking action will expand the scope of the current rule to incorporate prepaid care packages, wellness plans, payment plans, membership models, and concierge care models. The amended rule also prescribes the manner in which such financial arrangements and prepaid treatment plans must be documented and communicated to the patient, as well as the ability for the patient to cancel the financial arrangement at any time without penalty.
Texas Department of State Health Services
Proposed Rules Re:
Amending 25 TAC §§13.11, 13.13, 13.18, and 13.19, to remove references to the abolished Texas Health and Safety Code Chapter 104 from hospital data-collection rules, implementing House Bill 3801.
CHAPTER 13. HEALTH PLANNING AND RESOURCE DEVELOPMENT
SUBCHAPTER B. DATA COLLECTION
25 TAC §§13.11, 13.13, 13.18, 13.19
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), proposes amendments to §13.11, concerning Purpose and Scope; §13.13, concerning Definitions; §13.18, concerning Noncompliance with Reporting Requirements; §13.19, concerning Confidential Data; §13.51, concerning Purpose and Scope; and §13.85, concerning Award Criteria and Selection for Funding.
BACKGROUND AND JUSTIFICATION
The purpose of the proposal is to implement part of House Bill (HB) 3801, 89th Legislature, Regular Session, 2025, that repealed Texas Health and Safety Code (HSC) Chapter 104 and abolished the Statewide Health Coordinating Council (SHCC) and the nursing advisory committee (NAC) of that council effective September 1, 2025. The proposed amendments remove references to those topics from 25 Texas Administrative Code (TAC) Chapter 13.
SECTION-BY-SECTION SUMMARY
The proposed amendment to §13.11, Purpose and Scope, removes references to HSC Chapter 104 and incorporates plain language to improve readability.
The proposed amendment to §13.13, Definitions, removes references to HSC Chapter 104 and incorporates plain language to improve readability where applicable without changing definitions set in statute.
The proposed amendment to §13.18, Noncompliance with Reporting Requirements, removes references to HSC Chapter 104 and incorporates plain language to improve readability and clarity of the process to notify entities of noncompliance with reporting requirements.
The proposed amendment to §13.19, Confidential Data, removes references to HSC Chapter 104 and incorporates plain language to improve readability.
Amending 25 TAC §13.51, to remove references to the abolished Statewide Health Coordinating Council from Health Professions Resource Center data-collection rules, implementing House Bill 3801.
CHAPTER 13. HEALTH PLANNING AND RESOURCE DEVELOPMENT
SUBCHAPTER E. DATA COLLECTION
25 TAC §13.51
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), proposes amendments to §13.11, concerning Purpose and Scope; §13.13, concerning Definitions; §13.18, concerning Noncompliance with Reporting Requirements; §13.19, concerning Confidential Data; §13.51, concerning Purpose and Scope; and §13.85, concerning Award Criteria and Selection for Funding.
BACKGROUND AND JUSTIFICATION
The purpose of the proposal is to implement part of House Bill (HB) 3801, 89th Legislature, Regular Session, 2025, that repealed Texas Health and Safety Code (HSC) Chapter 104 and abolished the Statewide Health Coordinating Council (SHCC) and the nursing advisory committee (NAC) of that council effective September 1, 2025. The proposed amendments remove references to those topics from 25 Texas Administrative Code (TAC) Chapter 13.
SECTION-BY-SECTION SUMMARY
The proposed amendment to §13.51, Purpose and Scope, removes references to HSC Chapter 104 and incorporates plain language to improve readability.
Amending 25 TAC §13.85, to remove references to the abolished nursing advisory committee from Workplace Violence Against Nurses Prevention Grant Program award-criteria rules, implementing House Bill 3801.
CHAPTER 13. HEALTH PLANNING AND RESOURCE DEVELOPMENT
SUBCHAPTER G. WORKPLACE VIOLENCE AGAINST NURSES PREVENTION GRANT PROGRAM
25 TAC §13.85
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), proposes amendments to §13.11, concerning Purpose and Scope; §13.13, concerning Definitions; §13.18, concerning Noncompliance with Reporting Requirements; §13.19, concerning Confidential Data; §13.51, concerning Purpose and Scope; and §13.85, concerning Award Criteria and Selection for Funding.
BACKGROUND AND JUSTIFICATION
The purpose of the proposal is to implement part of House Bill (HB) 3801, 89th Legislature, Regular Session, 2025, that repealed Texas Health and Safety Code (HSC) Chapter 104 and abolished the Statewide Health Coordinating Council (SHCC) and the nursing advisory committee (NAC) of that council effective September 1, 2025. The proposed amendments remove references to those topics from 25 Texas Administrative Code (TAC) Chapter 13.
SECTION-BY-SECTION SUMMARY
The proposed amendment to §13.85, Award Criteria and Selection for Funding, removes references to the NAC and HSC §104.0155, and incorporates plain language to improve readability.
Statewide Health Coordinating Council
Proposed Rules Re:
Repealing 25 TAC §571.1 and §571.2, to remove obsolete rules following the abolition of the Statewide Health Coordinating Council, implementing House Bill 3801.
CHAPTER 571. HEALTH PLANNING AND RESOURCE DEVELOPMENT
SUBCHAPTER A. STATEWIDE HEALTH COORDINATING COUNCIL
25 TAC §571.1, §571.2
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), proposes the repeal of §571.1, concerning General Provisions, and §571.2, concerning State Health Plan and Plan Implementation.
BACKGROUND AND JUSTIFICATION
The purpose of the proposal is to implement part of House Bill (HB) 3801, 89th Legislature, Regular Session, 2025, that repealed Texas Health and Safety Code (HSC) Chapter 104 and abolished the Statewide Health Coordinating Council (SHCC) effective September 1, 2025. This proposal removes unnecessary rules from 25 Texas Administrative Code (TAC) Part 6, Statewide Health Coordinating Council, consisting of Chapter 571, Subchapter A, §571.1 and §571.2.
SECTION-BY-SECTION SUMMARY
The proposed repeal of §571.1 and §571.2 deletes the rules as they are no longer necessary.
Texas Health and Human Services Commission
Proposed Rules Re:
Adding new 26 TAC §505.27, to allow a general or special hospital license to include a mobile stroke unit, implementing House Bill 4743.
CHAPTER 505. HOSPITAL LICENSING
SUBCHAPTER B. HOSPITAL LICENSE
26 TAC §505.27
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §505.27, concerning Mobile Stroke Units.
BACKGROUND AND JUSTIFICATION
The proposal is necessary to comply with House Bill (HB) 4743, 89th Legislature, Regular Session, 2025. HB 4743 amended Texas Health and Safety Code (THSC) §241.023 to allow a general or special hospital license to include a mobile stroke unit (MSU).
The proposed rule outlines requirements for MSUs to exist as a part of a licensed hospital and specifies which existing licensing rules do not apply to MSUs. The proposed rule improves consistency between hospital licensing rules and THSC §241.023.
SECTION-BY-SECTION SUMMARY
Proposed new §505.27 outlines requirements for MSUs that: (1) allows HHSC to include an MSU in a hospital’s license; (2) specifies the guidelines for a hospital to apply to add an MSU to its license; (3) provides requirements to apply for a renewal license; (4) outlines necessary actions if a hospital or MSU no longer meet the requirements; (5) exempts MSUs from certain existing licensing rules; and (6) allows HHSC to conduct inspections for MSUs.
Amending 26 TAC §509.45, to allow freestanding emergency medical care facilities to grant medical staff privileges to board-certified emergency medicine physicians without requiring additional life-support certifications.
CHAPTER 509. FREESTANDING EMERGENCY MEDICAL CARE FACILITIES
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
26 TAC §509.45
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §509.45, concerning Medical Staff.
BACKGROUND AND JUSTIFICATION
In a freestanding emergency medical care (FEMC) facility licensed by HHSC, a physician must have at least one year of experience in emergency services, and current certification in advanced cardiac life support (ACLS), pediatric advanced life support (PALS), and advanced trauma life support (ATLS) to have medical staff privileges in the facility.
HHSC proposes to amend §509.45 to allow an FEMC facility to give medical staff privileges to physicians who are currently board certified in emergency medicine from the American Board of Emergency Medicine (ABEM) or the American Osteopathic Board of Emergency Medicine (AOBEM) with the required experience and without requiring current certification in ACLS, PALS, and ATLS. The proposal is in response to requests from providers, and because HHSC determined that emergency medicine board certification from the ABEM or AOBEM ensures a physician has the required knowledge and skills related to emergency life support without having additional life support certifications.
The proposed amendment addresses concerns from providers and physicians that additional certifications for board certified emergency room physicians creates an additional regulatory hardship for FEMC facilities.
Additionally, the proposed amendment contains requirements for a physician with an expired ABEM or AOBEM board certification to be granted medical staff privileges in an FEMC facility.
SECTION-BY-SECTION SUMMARY
The proposed amendment to §509.45 adds new subsection (e) to move the current requirements in subsection (d)(5) for a physician to have medical staff privileges in an FEMC facility.
The proposed amendment adds new subsection (f) to allow an FEMC facility to grant medical staff privileges to a physician with at least one year of experience in emergency services and current board certified in emergency medicine from the ABEM or AOBEM without having the certifications required in proposed subsection (e).
The proposed amendment adds new subsection (g) that contains the requirements for a physician with an expired ABEM or AOBEM board certification and at least one year of experience in emergency services to be granted medical staff privileges in an FEMC facility.
The proposed amendment in subsection (a), subsection (c)(4) and (5), and subsection (d) makes minor edits to improve the clarity and meaning of these rules.
Adopted Rules Re:
Amending 26 TAC §550.5, concerning Definitions, as part of the Prescribed Pediatric Extended Care Center background-check rules implementing Senate Bill 1849.
CHAPTER 550. LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS
SUBCHAPTER A. PURPOSE, SCOPE, LIMITATIONS, COMPLIANCE, AND DEFINITIONS
26 TAC §550.5
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §550.5, concerning Definitions; §550.304, concerning Administrator Responsibilities; §550.406, concerning Student Nurses; §550.413, concerning Contractors; §550.415, concerning Staffing Policies for Staff Orientation, Development, and Training; §550.417, concerning Personnel Records; and §550.418, concerning Criminal History Checks, Nurse Aide Registry, Medication Aide Registry, and Search Engine for Multi-Agency Reportable Conduct Requirements.
Section 550.418 is adopted with changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2185). This rule will be republished.
Sections 550.5, 550.304, 550.406, 550.413, 550.415, and 550.417 are adopted without changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2185). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
The amendments are necessary to implement Senate Bill 1849, 88th Legislature, Regular Session, 2023, which created Texas Health and Safety Code Chapter 810, Interagency Reportable Conduct Search Engine. While the Texas Department of Information Resources was responsible for creating the search engine, the chapter also required HHSC to amend rules relating to the Employee Misconduct Registry search engine and required background check searches providers regulated by HHSC Long-Term Care Regulation (LTCR) must conduct before employing individuals.
Amending 26 TAC §550.304, concerning Administrator Responsibilities, as part of the Prescribed Pediatric Extended Care Center background-check rules implementing Senate Bill 1849.
CHAPTER 550. LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS
SUBCHAPTER C. GENERAL PROVISIONS
DIVISION 2. ADMINISTRATION AND MANAGEMENT
26 TAC §550.304
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §550.5, concerning Definitions; §550.304, concerning Administrator Responsibilities; §550.406, concerning Student Nurses; §550.413, concerning Contractors; §550.415, concerning Staffing Policies for Staff Orientation, Development, and Training; §550.417, concerning Personnel Records; and §550.418, concerning Criminal History Checks, Nurse Aide Registry, Medication Aide Registry, and Search Engine for Multi-Agency Reportable Conduct Requirements.
Section 550.418 is adopted with changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2185). This rule will be republished.
Sections 550.5, 550.304, 550.406, 550.413, 550.415, and 550.417 are adopted without changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2185). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
The amendments are necessary to implement Senate Bill 1849, 88th Legislature, Regular Session, 2023, which created Texas Health and Safety Code Chapter 810, Interagency Reportable Conduct Search Engine. While the Texas Department of Information Resources was responsible for creating the search engine, the chapter also required HHSC to amend rules relating to the Employee Misconduct Registry search engine and required background check searches providers regulated by HHSC Long-Term Care Regulation (LTCR) must conduct before employing individuals.
Amending 26 TAC §§550.406, 550.413, 550.415, 550.417, and 550.418, concerning nursing and staffing requirements including Search Engine for Multi-Agency Reportable Conduct background-check procedures, implementing Senate Bill 1849.
CHAPTER 550. LICENSING STANDARDS FOR PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS
SUBCHAPTER C. GENERAL PROVISIONS
DIVISION 3. NURSING AND STAFFING REQUIREMENTS
26 TAC §§550.406, 550.413, 550.415, 550.417, 550.418
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §550.5, concerning Definitions; §550.304, concerning Administrator Responsibilities; §550.406, concerning Student Nurses; §550.413, concerning Contractors; §550.415, concerning Staffing Policies for Staff Orientation, Development, and Training; §550.417, concerning Personnel Records; and §550.418, concerning Criminal History Checks, Nurse Aide Registry, Medication Aide Registry, and Search Engine for Multi-Agency Reportable Conduct Requirements.
Section 550.418 is adopted with changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2185). This rule will be republished.
Sections 550.5, 550.304, 550.406, 550.413, 550.415, and 550.417 are adopted without changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2185). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
The amendments are necessary to implement Senate Bill 1849, 88th Legislature, Regular Session, 2023, which created Texas Health and Safety Code Chapter 810, Interagency Reportable Conduct Search Engine. While the Texas Department of Information Resources was responsible for creating the search engine, the chapter also required HHSC to amend rules relating to the Employee Misconduct Registry search engine and required background check searches providers regulated by HHSC Long-Term Care Regulation (LTCR) must conduct before employing individuals.
Amending 26 TAC §553.257, concerning Personnel, to implement Search Engine for Multi-Agency Reportable Conduct background-check requirements for assisted living facilities, per Senate Bill 1849.
CHAPTER 553. LICENSING STANDARDS FOR ASSISTED LIVING FACILITIES
SUBCHAPTER E. STANDARDS FOR LICENSURE
26 TAC §553.257
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts an amendment to §553.257, concerning Personnel.
Section 553.257 is adopted with changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2194). This rule will be republished.
BACKGROUND AND JUSTIFICATION
The amendment is necessary to implement Senate Bill 1849, 88th Legislature, Regular Session, 2023, which created Texas Health and Safety Code Chapter 810, Interagency Reportable Conduct Search Engine. While the Texas Department of Information Resources was responsible for creating the search engine, the chapter also required HHSC to amend rules relating to the Employee Misconduct Registry search engine and required background check searches providers regulated by HHSC Long-Term Care Regulation (LTCR) must conduct before employing individuals.
Amending 26 TAC §554.101, concerning Definitions, as part of the nursing facility background-check rules implementing Senate Bill 1849.
CHAPTER 554. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
SUBCHAPTER B. DEFINITIONS
26 TAC §554.101
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §554.101, concerning Definitions; and §554.1921, concerning General Requirements for a Nursing Facility.
Section 554.1921 is adopted with changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2196). This rule will be republished.
Section 554.101 is adopted without changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2196). This rule will not be republished.
BACKGROUND AND JUSTIFICATION
The amendments are necessary to implement Senate Bill 1849, 88th Legislature, Regular Session, 2023, which created Texas Health and Safety Code Chapter 810, Interagency Reportable Conduct Search Engine. While the Texas Department of Information Resources was responsible for creating the search engine, the chapter also required HHSC to amend rules relating to the Employee Misconduct Registry search engine and required background check searches providers regulated by HHSC Long-Term Care Regulation (LTCR) must conduct before employing individuals.
Amending 26 TAC §554.1921, concerning General Requirements for a Nursing Facility, to add Search Engine for Multi-Agency Reportable Conduct background-check procedures, implementing Senate Bill 1849.
CHAPTER 554. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
SUBCHAPTER T. ADMINISTRATION
26 TAC §554.1921
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §554.101, concerning Definitions; and §554.1921, concerning General Requirements for a Nursing Facility.
Section 554.1921 is adopted with changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2196). This rule will be republished.
Section 554.101 is adopted without changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2196). This rule will not be republished.
BACKGROUND AND JUSTIFICATION
The amendments are necessary to implement Senate Bill 1849, 88th Legislature, Regular Session, 2023, which created Texas Health and Safety Code Chapter 810, Interagency Reportable Conduct Search Engine. While the Texas Department of Information Resources was responsible for creating the search engine, the chapter also required HHSC to amend rules relating to the Employee Misconduct Registry search engine and required background check searches providers regulated by HHSC Long-Term Care Regulation (LTCR) must conduct before employing individuals.
Amending 26 TAC §555.42, concerning Alternate Licensing Requirements for Military Service Personnel, to implement Search Engine for Multi-Agency Reportable Conduct background-check requirements for nursing facility administrators, per Senate Bill 1849.
CHAPTER 555. NURSING FACILITY ADMINISTRATORS
SUBCHAPTER C. LICENSES
26 TAC §555.42
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts an amendment to §555.42, concerning Alternate Licensing Requirements for Military Service Personnel.
Section 555.42 is adopted without changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2206). This rule will not be republished.
BACKGROUND AND JUSTIFICATION
The amendment is necessary to implement Senate Bill 1849, 88th Legislature, Regular Session, 2023, which created Texas Health and Safety Code Chapter 810, Interagency Reportable Conduct Search Engine. While the Texas Department of Information Resources was responsible for creating the search engine, the chapter also required HHSC to amend rules relating to the Employee Misconduct Registry search engine and required background check searches for nursing facility administrators.
Amending 26 TAC §§556.3, 556.12 – 556.14, concerning nurse aide training, waiver, reciprocity, and findings requirements, to add Search Engine for Multi-Agency Reportable Conduct background-check procedures, implementing Senate Bill 1849.
CHAPTER 556. NURSE AIDES
26 TAC §§556.3, 556.12 – 556.14
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §556.3, concerning Nurse Aide Training and Competency Evaluation Program (NATCEP) Requirements; §556.12, concerning Waiver, Reciprocity, and Exemption Requirements; §556.13, concerning Findings and Inquiries; and §556.14, concerning Alternate Licensing Requirements for Military Service Personnel.
Sections 556.3, 556.12, and 556.13 are adopted with changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2209). These rules will be republished.
Section 556.14 is adopted without changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2209). This rule will not be republished.
BACKGROUND AND JUSTIFICATION
The amendments are necessary to implement Senate Bill 1849, 88th Legislature, Regular Session, 2023, which created Texas Health and Safety Code, Chapter 810, Interagency Reportable Conduct Search Engine. While the Texas Department of Information Resources was responsible for creating the search engine, the chapter also required HHSC to amend rules relating to the Employee Misconduct Registry search engine and required background check searches providers regulated by HHSC Long-Term Care Regulation (LTCR) or HHSC must conduct before employing individuals.
Amending 26 TAC §§557.107, 557.113, 557.115, 557.119, and 557.129, concerning medication aide training, eligibility, and renewal requirements, to add Search Engine for Multi-Agency Reportable Conduct background-check procedures, implementing Senate Bill 1849.
CHAPTER 557. MEDICATION AIDES–PROGRAM REQUIREMENTS
26 TAC §§557.107, 557.113, 557.115, 557.119, 557.129
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §557.107, concerning Training Requirements; Nursing Graduates; Reciprocity; §557.113, concerning Determination of Eligibility; §557.115, concerning Permit Renewal; §557.119, concerning Training Program Requirements; and §557.129, concerning Alternate Licensing Requirements for Military Service.
Sections 557.107, 557.113, 557.115, and 557.119 are adopted with changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2216). These rules will be republished.
Section 557.129 is adopted without changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2216). This rule will not be republished.
BACKGROUND AND JUSTIFICATION
The amendments are necessary to implement Senate Bill 1849, 88th Legislature, Regular Session, 2023, which created Texas Health and Safety Code Chapter 810, Interagency Reportable Conduct Search Engine. While the Texas Department of Information Resources was responsible for creating the search engine, the chapter also required HHSC to amend rules relating to the Employee Misconduct Registry search engine and required background check searches providers regulated by HHSC Long Term Care Regulatory (LTCR) or HHSC must conduct before employing individuals.
Amending 26 TAC §559.3, concerning Definitions, as part of the day activity and health services background-check rules implementing Senate Bill 1849.
CHAPTER 559. DAY ACTIVITY AND HEALTH SERVICES REQUIREMENTS
SUBCHAPTER A. INTRODUCTION
26 TAC §559.3
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §559.3, concerning Definitions; §559.51, concerning Compliance; and §559.225, concerning General Requirements.
Sections 559.3, 559.51, and 559.225 are adopted with changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2223). These rules will be republished.
BACKGROUND AND JUSTIFICATION
The amendments are necessary to implement Senate Bill 1849, 88th Legislature, Regular Session, 2023, which created Texas Health and Safety Code Chapter 810, Interagency Reportable Conduct Search Engine. While the Texas Department of Information Resources was responsible for creating the search engine, the chapter also required HHSC to amend rules relating to the Employee Misconduct Registry search engine and required background check searches providers regulated by HHSC Long-Term Care Regulation (LTCR) must conduct before employing individuals.
Amending 26 TAC §559.51, concerning Compliance, to add Search Engine for Multi-Agency Reportable Conduct background-check procedures for day activity and health services facilities, implementing Senate Bill 1849.
CHAPTER 559. DAY ACTIVITY AND HEALTH SERVICES REQUIREMENTS
SUBCHAPTER D. STANDARDS FOR LICENSURE
26 TAC §559.51
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §559.3, concerning Definitions; §559.51, concerning Compliance; and §559.225, concerning General Requirements.
Sections 559.3, 559.51, and 559.225 are adopted with changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2223). These rules will be republished.
BACKGROUND AND JUSTIFICATION
The amendments are necessary to implement Senate Bill 1849, 88th Legislature, Regular Session, 2023, which created Texas Health and Safety Code Chapter 810, Interagency Reportable Conduct Search Engine. While the Texas Department of Information Resources was responsible for creating the search engine, the chapter also required HHSC to amend rules relating to the Employee Misconduct Registry search engine and required background check searches providers regulated by HHSC Long-Term Care Regulation (LTCR) must conduct before employing individuals.
CHAPTER 559. DAY ACTIVITY AND HEALTH SERVICES REQUIREMENTS
SUBCHAPTER H. INDIVIDUALIZED SKILLS AND SOCIALIZATION PROVIDER REQUIREMENTS
DIVISION 3. PROVIDER REQUIREMENTS
26 TAC §559.225
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §559.3, concerning Definitions; §559.51, concerning Compliance; and §559.225, concerning General Requirements.
Sections 559.3, 559.51, and 559.225 are adopted with changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2223). These rules will be republished.
BACKGROUND AND JUSTIFICATION
The amendments are necessary to implement Senate Bill 1849, 88th Legislature, Regular Session, 2023, which created Texas Health and Safety Code Chapter 810, Interagency Reportable Conduct Search Engine. While the Texas Department of Information Resources was responsible for creating the search engine, the chapter also required HHSC to amend rules relating to the Employee Misconduct Registry search engine and required background check searches providers regulated by HHSC Long-Term Care Regulation (LTCR) must conduct before employing individuals.
Amending 26 TAC §560.4, concerning Registry Listings Barring Licensure, to add the Search Engine for Multi-Agency Reportable Conduct as a bar to facility licensure, implementing Senate Bill 1849.
CHAPTER 560. DENIAL OR REFUSAL OF LICENSE
26 TAC §560.4
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts an amendment to §560.4, concerning Registry Listings Barring Licensure.
Section 560.4 is adopted with changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2230). This rule will be republished.
BACKGROUND AND JUSTIFICATION
The amendment is necessary to implement Senate Bill 1849, 88th Legislature, Regular Session, 2023, which created Texas Health and Safety Code Chapter 810, Interagency Reportable Conduct Search Engine. While the Texas Department of Information Resources was responsible for creating the search engine, the chapter also required HHSC to amend rules relating to the Employee Misconduct Registry search engine and required background check searches for providers regulated by HHSC Long-Term Care Regulation (LTCR).
Amending 26 TAC §565.9, concerning Program Provider Requirements, to add Search Engine for Multi-Agency Reportable Conduct background-check procedures for HCS/CFC program providers, implementing Senate Bill 1849.
CHAPTER 565. HOME AND COMMUNITY-BASED (HCS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) CERTIFICATION STANDARDS
SUBCHAPTER D. CERTIFICATION STANDARDS: STAFF MEMBER AND SERVICE PROVIDER REQUIREMENTS
26 TAC §565.9
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts an amendment to §565.9, concerning Program Provider Requirements.
Section 565.9 is adopted with changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2231). This rule will be republished.
BACKGROUND AND JUSTIFICATION
The amendment is necessary to implement Senate Bill 1849, 88th Legislature, Regular Session, 2023, which created Texas Health and Safety Code Chapter 810, Interagency Reportable Conduct Search Engine. While the Texas Department of Information Resources was responsible for creating the search engine, the chapter also required HHSC to amend rules relating to the Employee Misconduct Registry search engine and required background check searches providers regulated by HHSC Long-Term Care Regulation (LTCR) must conduct before employing individuals.
Amending 26 TAC §566.9, concerning Certification Principles: Staff Member and Service Provider Requirements, to add Search Engine for Multi-Agency Reportable Conduct background-check procedures for TxHmL/CFC program providers, implementing Senate Bill 1849.
CHAPTER 566. TEXAS HOME LIVING (TXHML) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) CERTIFICATION STANDARDS
26 TAC §566.9
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts an amendment to §566.9, concerning Certification Principles: Staff Member and Service Provider Requirements.
Section 566.9 is adopted with changes to the proposed text as published in the April 3, 2026, issue of the Texas Register (51 TexReg 2233). This rule will be republished.
BACKGROUND AND JUSTIFICATION
The amendment is necessary to implement Senate Bill 1849, 88th Legislature, Regular Session, 2023, which created Texas Health and Safety Code Chapter 810, Interagency Reportable Conduct Search Engine. While the Texas Department of Information Resources was responsible for creating the search engine, the chapter also required HHSC to amend rules relating to the Employee Misconduct Registry search engine and required background check searches providers regulated by HHSC Long-Term Care Regulation (LTCR) must conduct before employing individuals.
In Addition Re:
Correction of Error
The Health and Human Services Commission proposed amendments to 26 TAC §747.501 and §747.701 in the July 10, 2026, issue of the Texas Register (51 TexReg 4519). Due to an error by the Texas Register, several items in the proposal were published incorrectly.
Implied subsection (a) of 26 TAC §747.501 should read as follows:
A child care home must develop written operational policies and procedures that address:
Implied subsection (a) of 26 TAC §747.701 should read as follows:
A child care home must keep written records of accidents and incidents that happen while a child is in care. A child care home must use the Child Care Regulation Incident or Illness Report form, or another form with the same information, to record:
Texas Board of Nursing
Adopted Rules Re:
Amending 22 TAC §§216.1, 216.5, 216.7 – 216.9, and 216.11, to establish and integrate a continuing education tracking system for verifying licensee compliance with continuing competency requirements, implementing Senate Bill 912.
CHAPTER 216. CONTINUING COMPETENCY
22 TAC §§216.1, 216.5, 216.7 – 216.9, 216.11
OVERVIEW
The Texas Board of Nursing (Board) adopts amendments to 22 Texas Administrative Code §§216.1, 216.5, 216.7, 216.8, 216.9, and 216.11, without changes to the proposed text published in the March 20, 2026, issue of the Texas Register (51 TexReg 1789), as corrected by the Texas Register’s Correction of Error (51 TexReg 4612). The rule will not be republished.
BACKGROUND AND JUSTIFICATION
The Texas Board of Nursing (Board) adopts amendments to Board Rules §§216.1, 216.5, 216.7 – 216.9 and 216.11 to implement the requirements of Senate Bill 912, which added Texas Occupations Code §§112.101-112.106. This bill requires the Board to establish a continuing education tracking system to verify that licensees have complied with continuing competency requirements prior to renewal of a license. The amendments to 22 Texas Administrative Code Chapter 216, relating to Continuing Competency, implement Senate Bill 912 by establishing and integrating a continuing education tracking system for verifying licensee compliance.
SECTION-BY-SECTION SUMMARY
Section 216.1 contains definitions for Chapter 216. The Board revises the definition of “Audit” to clarify that audits may involve a general review of licensees and monitoring of the continuing education tracking system vendor, rather than being limited to a random sampling conducted during a biennial licensing period. The amendments also add a new definition for “Continuing education tracking system,” defined as an electronic system established by the Board in accordance with Texas Occupations Code §§112.104 and 112.105. Existing definitions in the section are renumbered as necessary to accommodate the addition of the new term.
Section 216.5 establishes additional methods by which a licensee may demonstrate compliance with continuing competency requirements, other than by submitting evidence of completed continuing nursing education (CNE) hours or an approved national nursing certification. The amendments to §216.5 transition documentation requirements for these alternative methods from the current reactive, audit-based submission process to a proactive requirement that licensees upload sufficient documentation and information to the continuing education tracking system. Under the amendments, licensees are required to upload documentation verifying completion of qualifying academic courses, development or presentation of approved programs, and publication of eligible manuscripts, rather than submitting documentation only upon audit.
Section 216.7 establishes the responsibilities of individual licensees with respect to recordkeeping and verification of continuing competency activities. The amendments to §216.7 clarify these responsibilities by maintaining the requirement that licensees retain records of general continuing nursing education activities for a minimum of three consecutive licensing periods, while proposing removal of language specifying forms of documentation to be submitted upon audit. The amendments also add a provision requiring licensees to upload all documentation and information necessary to verify completion of continuing competency requirements to the continuing education tracking system prior to license renewal or reactivation.
Section 216.8 establishes the process for renewal, reactivation, and other forms of relicensure. The amendments to §216.8 incorporate use of the continuing education tracking system into the relicensure framework by proposing that licensees attest, upon renewal, that they have complied with the requirement to upload verification documentation to the tracking system. The amendments further require that licensees seeking renewal of a delinquent license or reactivation of an inactive license upload sufficient documentation to the tracking system to verify completion of required continuing education or maintenance of approved national nursing certification. Additional conforming amendments align the renewal, delinquency, and reactivation processes with the verification framework.
Section 216.9 establishes the Board’s audit process for verifying compliance with continuing competency requirements. The amendments to §216.9 align the audit process with the continuing education tracking system by proposing that the Board review documentation and information previously uploaded to the system and request additional materials as necessary to verify compliance. The amendments also remove obsolete provisions describing prior random sampling procedures and specific submission formats in order to comport with the proposed continuing education tracking system procedures.
Section 216.11 establishes the consequences of noncompliance with continuing competency requirements. The amendments to §216.11 clarify that failure to demonstrate compliance upon audit, falsely attesting to completion of continuing competency requirements, or falsification of records would constitute unprofessional conduct and grounds for disciplinary action, in addition to denial of license renewal.