Texas Register Table of Contents
Texas Department of Licensing and Regulation
Proposed Rules Re:
Amending 16 TAC §121.10, §§121.20 – 121.22, 121.25, 121.26, §§121.65, 121.67, 121.68, §§121.70 – 121.75, §§121.76 – 121.81, §121.85, §121.90, and §121.95, and proposing new 16 TAC §121.100, to implement SB 2075 (89th Legislature) by updating the Behavior Analyst program rules to correct outdated terminology, recognize the Qualified Applied Behavior Analysis Credentialing Board as a second approved certifying entity, extend the advisory board presiding officer’s term from one to two years, establish new ethics requirements governing the use of artificial intelligence systems by license holders, and update the complaint intake process to reflect the Department’s exclusive use of an online and postal mail system.
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC, Chapter 121, implement Texas Occupations Code, Chapter 506, Behavior Analysts.
The proposed rules are necessary to implement the statutory changes made by Senate Bill (SB) 2075, 89th Legislature, Regular Session (2025), specifically, Section 18. The proposed rules amend and correct outdated terminology, simplify and clarify commonly used terms, explain new ethical requirements related to the use of artificial intelligence systems, and update the complaint process.
These changes are also necessary to implement technical clean-up changes and other changes recommended by Department staff during the Department’s 4-year rule review, and also from recommendations generated during discussions between the Department and members of the Behavior Analyst Advisory Board regarding the use of artificial intelligence systems by behavior analysts.
The proposed rules are necessary to ensure consistency with plain language principles, to recognize the Qualified Applied Behavior Analysis Credentialing Board as a certifying entity, to change the advisory board presiding officer’s term from one year to two years, to describe the ethical requirements imposed on behavior analysis licensees who use artificial intelligence systems to provide service to their clients, and to update the complaint process to reflect the Department’s exclusive use of an on-line complaint intake system.
SECTION-BY-SECTION SUMMARY
Subchapter A. General Provisions
The proposed rules add new rules for §121.10. Definitions. The proposed rules add definitions for “Artificial intelligence system (AI),” “Deidentified,” and “Qualified Applied Behavior Analysis Credentialing Board (QABA).” These new definitions are used extensively throughout the remainder of Ch. 121, especially in the new proposed subsection §121.751, License Holder Responsibilities Related to the Use of AIs (see below). The proposed rules also amend and renumber §121.10 to accommodate these new rules.
Subchapter B. Licensing Requirements
The proposed rules amend §121.20, Applications; §121.21, Behavior Analyst Licensing Requirements; §121.22, Assistant Behavior Analyst Licensing Requirements; §121.25, Continuing Education; and §121.26. Renewal.
The proposed rules under subsection §121.20(c)(1) amend and correct outdated terminology by changing “college work” to “course work.” The proposed rules under subsection §121.20(c)(8), §121.21(a)(1) and (3), §121.22(a)(1) and (4), §121.25(a), and §121.26(c)(2) amend and correct outdated terminology by referring generally to behavior analyst certifications issued by certifying entities, rather than specifically to the Behavior Analyst Certification Board (BACB). This amendment reflects the Department’s approval of the Qualified Applied Behavior Analysis Credentialing Board (QABA) as a certifying entity alongside the BACB.
The proposed rules amend and correct outdated terminology in rule §121.25 by changing “shall” to “must.”
Subchapter C. Behavior Analyst Advisory Board
The proposed rules amend §121.65, Membership; §121.67, Terms, Vacancies; and §121.68, Officers. The proposed rules amend §121.68(a) in accordance with SB 2075, 89th Legislature, Regular Session (2025) to change the advisory board presiding officer’s term from one year to two years.
The proposed rules amend and correct outdated terminology in rules §121.65 and §121.67, by changing “shall” to “is,” “shall include” to “is as follows,” and “shall be” to “is.”
Subchapter D. Responsibilities of License Holder
The proposed rules amend §121.70, Administrative Practice Responsibilities of License Holders; §121.71, Professional Services Practice Responsibilities of License Holders; §121.72, Display of License; §121.73, Reporting Requirements; §121.74, Reporting Requirements; and §121.75, Code of Ethics.
The proposed rules under subsection §121.71(a)(4) and §121.75(a) amend and correct outdated terminology by referring generally to behavior analyst certifications issued by certifying entities. This amendment reflects the Department’s approval of the QABA as a certifying entity alongside the BACB.
The proposed rules amend and correct outdated terminology in rules §§121.70, 121.71, 121.72, 121.73, 121.74, and 121.75 by changing “shall” to “must.”
The proposed rules add new rules to §121.75, Code of Ethics. Specifically, new (b)(12) – (14) require license holders to obtain a client’s written consent before using client data for research or for use by artificial intelligence (AI) and require license holders to document unauthorized disclosures of the client’s data, including disclosures caused by any breach of an AI system. The proposed rules also amend and renumber §121.75(b) to accommodate these new rules.
Subchapter E. Telehealth
The proposed rules amend §121.76, Definitions Relating to Telehealth; §121.77, Service Delivery Models; §121.78, Technology and Equipment Requirements; §121.79, License Holder Responsibilities for Providing Telehealth Services and Using Telehealth; §121.80, Use of Facilitators with Telehealth; and §121.81, Client Contacts and Communications.
The proposed rules amend and correct outdated terminology in rules §§121.76, 121.77, 121.78, 121.79, 121.80, and 121.81 by repealing “shall,” changing “shall be” to “is,” and changing “shall” to “must.”
Subchapter F. Fees
The proposed rules amend §121.85, Fees. The proposed rules amend and correct outdated terminology in rule §121.85(b)(1) and (2) by repealing “application and initial” from the description of the licensing fees for behavior analysts and assistant behavior analysts, as the fee is the same for both applicants and for the initial licensure.
Subchapter G. Enforcement
The proposed rules amend §121.90, Basis for Disciplinary Action; and §121.95, Complaints.
The proposed rules under subsection §121.90(b) amend and correct outdated terminology by referring generally to behavior analyst certifications issued by certifying entities. This amendment reflects the Department’s approval of the QABA as a certifying entity alongside the BACB.
The proposed rules under subsection §121.95(a) amend the Department’s complaint intake process by requiring the Department to list a web address, mailing address, and business number for the purpose of accepting complaints. This amendment is necessary because the Department no longer accepts complaints via telephone, as its complaint intake process is now exclusively online or by postal mail.
The proposed rules amend and correct outdated terminology in rule §121.95 by changing “shall list with” to “will provide,” and “shall” to “must.”
Subchapter H. License Holder Responsibilities Related to the Use of AIs
The proposed rules add a new subchapter, Subchapter H, License Holder Responsibilities Related to the Use of AIs.
The proposed rules add new subsection, §121.100, License Holder Responsibilities Related to the Use of AIs. New (a) prohibits license holders from using AI as the sole basis for treatment design, assessment, implementation, reports, or evaluations. New (b) requires license holders to personally review any AI-generated or AI-assisted treatment materials. New (c) requires that any restrictive or punishment-based procedures suggested by AI require the license holder to ensure that less intrusive methods are not viable, that the benefits of the restrictive or punishment-based procedures outweigh risks of harm, and to document the rationale for this decision in the client’s file. New (d) requires license holders not to use AI to treat clients if the use of AI would be beyond their training or their scope of licensure. New (e) requires that all AI-derived information must be verified by the license holder and based on accurate evidence and requires the license holder to document this verification in the client’s file. New (f) requires that license holders must explain the evidence behind any AI-driven changes to a client’s treatment plan to their client in clear, understandable language and requires the license holder to document this explanation in the client’s file. Finally, new (g) requires that all AI-influenced modifications to a client’s treatment plan are based on evidence personally confirmed by the license holder.
Texas State Board of Pharmacy
Proposed Rule Reviews Re:
Reviewing Title 22, Part 15, to consider for readoption, revision, or repeal the chapter concerning Administrative Practices and Procedures.
The Texas State Board of Pharmacy files this notice of intent to review Chapter 281 (§§281.1 – 281.23, 281.30 – 281.35, 281.60 – 281.70), concerning Administrative Practices and Procedures, pursuant to Texas Government Code §2001.039, regarding Agency Review of Existing Rules.
Reviewing Title 22, Part 15, to consider for readoption, revision, or repeal the chapter concerning Code of Conduct.
The Texas State Board of Pharmacy files this notice of intent to review Chapter 311 (§311.1 and §311.2), concerning Code of Conduct, pursuant to Texas Government Code §2001.039, regarding Agency Review of Existing Rules.
Texas Health and Human Services Commission
Adopted Rule Reviews Re:
Adopting Title 26, Part 1, concerning Limited Services Rural Hospitals.
The Texas Health and Human Services Commission (HHSC) adopts the review of the chapter below in Title 26, Part 1, of the Texas Administrative Code (TAC):
Chapter 511, Limited Services Rural Hospitals
Notice of the review of this chapter was published in the February 20, 2026, issue of the Texas Register (51 TexReg 1175).
HHSC received four comments concerning this chapter from the Texas Society of Anesthesiologists. A summary of comments and HHSC’s responses follows.
Comment: The commenter recommends amending §511.56(d) to clarify that a registered nurse without a nurse anesthetist certification may only administer certain anesthetic medication under the orders of a physician or dentist by removing the phrase “or other authorized practitioner.” The commenter references Texas Occupations Code §157.001 as the rationale for this recommendation.
Response: HHSC acknowledges this comment but declines to modify the rule in response. HHSC determined that this request may impact multiple stakeholder groups. In addition, the Regulatory Services Division of HHSC will review the limited services rural hospital (LSRH) rules again as part of its current regulatory reform initiative. As with all rulemaking efforts, the public will have an opportunity to review and comment on future proposed rules.
Comment: The commenter recommends amending §511.56(e) to include dentists as additional medical professionals who may be consulted prior to the administration of anesthesia before a procedure.
Response: HHSC acknowledges this comment but declines to modify the rule in response. HHSC must determine whether the requested change aligns with standard practices across provider and facility types. In addition, the Regulatory Services Division of HHSC will review the LSRH rules again as part of its current regulatory reform initiative. As with all rulemaking efforts, the public will have an opportunity to review and comment on future proposed rules.
Comment: The commenter recommends amending §511.56(f) to add the American Academy of Anesthesiologist Assistants to the list of professional association guidelines that an LSRH must consider when establishing licensing rules and standards for qualified to anesthesia professionals.
Response: HHSC acknowledges this comment but declines to modify the rule until HHSC verifies the association guidelines are consistent with the industry standards of the other organizations on the list. In addition, the Regulatory Services Division of HHSC will review the LSRH rules again as part of its current regulatory reform initiative. As with all rulemaking efforts, the public will have an opportunity to review and comment on future proposed rules.
Comment: The commenter recommends amending §511.56(l)(3) to clarify the language related to pulse oximetry by replacing “a mechanism for monitoring blood oxygenation, such as pulse oximetry;” with “continuous pulse oximetry and capnography monitoring for moderate and deep sedation” to align the existing rule with best practices within the anesthesia specialty.
Response: HHSC acknowledges this comment but declines to modify the rule in response. HHSC determined the update may be too prescriptive and inconsistent with industry standards of practice. In addition, the Regulatory Services Division of HHSC will review the LSRH rules again as part of its current regulatory reform initiative. As with all rulemaking efforts, the public will have an opportunity to review and comment on future proposed rules.
HHSC has reviewed Chapter 511 in accordance with Texas Government Code §2001.039, which requires state agencies to assess, every four years, whether the initial reasons for adopting a rule continue to exist.
The agency determined that the original reasons for adopting all rules in the chapter continue to exist and readopts Chapter 511. Any amendments, if applicable, to Chapter 511 identified by HHSC in the rule review will be proposed in a future issue of the Texas Register.