20 Jun 2025

Texas Register June 20, 2025 Volume: 50 Number: 25

by | posted in: Governor, State Board of Dental Examiners, Texas Department of State Health Services, Texas Health and Human Services Commission, Uncategorized |

Texas Register Table of Contents

Governor

Appointments Re:

Appointed to the Texas State Board of Examiners of Professional Counselors for a term to expire February 1, 2029, Nadia M. Stewart.
Appointed to the One-Call Board of Texas for a term to expire August 31, 2026, Keith L. Wall.
Appointed to the Texas State Board of Examiners of Psychologists for a term to expire October 31, 2027, Brian E. Rentsch.

State Board of Dental Examiners

Proposed Rules Re:

Amending 22 TAC §101.1, to require applicants to submit a National Practitioner Data Bank self-query report upon initial licensure.

CHAPTER 101. DENTAL LICENSURE
22 TAC §101.1

OVERVIEW

The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §101.1, pertaining to general qualifications for dental licensure. The proposed amendment requires applicants to submit a National Practitioner Data Bank self-query report upon initial licensure. Initial applicants currently submit this report to the Board as part of the licensing application process; this amendment is proposed to reflect the Board’s current process.

Amending 22 TAC §101.2, to revise the remediation requirements by increasing flexibility on when to take a remediation course and allowing Board staff to approve the remediation course.

CHAPTER 101. DENTAL LICENSURE
22 TAC §101.2

OVERVIEW

The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §101.2, pertaining to dental licensure by examination. The proposed amendment reflects the merger of Central Regional Dental Testing Service (CRDTS) with the States Resources for Testing and Assessments (SRTA). The proposed amendment also changes the remediation requirements by (1) allowing applicants to take a remediation course before or after passing an examination to give applicants flexibility on when to take the course, and (2) allowing Board staff to approve the remediation course.

Amending 22 TAC §103.1, to require applicants to submit a National Practitioner Data Bank self-query report upon initial licensure.

CHAPTER 103. DENTAL HYGIENE LICENSURE
22 TAC §103.1

OVERVIEW

The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §103.1, pertaining to general qualifications for hygiene licensure. The proposed amendment requires applicants to submit a National Practitioner Data Bank self-query report upon initial licensure. Initial applicants currently submit this report to the Board as part of the licensing application process; this amendment is proposed to reflect the Board’s current process.

Amending 22 TAC §103.2, to reflect the broader merger of Central Regional Dental Testing Service (CRDT) with the States Resources for Testing and Assessments (SRTA).

CHAPTER 103. DENTAL HYGIENE LICENSURE
22 TAC §103.2

OVERVIEW

The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §103.2, pertaining to dental hygiene licensure by examination. The proposed amendment reflects the merger of Central Regional Dental Testing Service (CRDTS) with the States Resources for Testing and Assessments (SRTA).

Amending 22 TAC §104.1, to reflect the broader merger of Central Regional Dental Testing Service (CRDT) with the States Resources for Testing and Assessments (SRTA).

CHAPTER 104. CONTINUING EDUCATION
22 TAC §104.1

OVERVIEW

The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §104.1, pertaining to continuing education requirements. The proposed amendment reflects the merger of Central Regional Dental Testing Service (CRDTS) with the States Resources for Testing and Assessments (SRTA).

Amending 22 TAC §104.2, to reflect the broader merger of Central Regional Dental Testing Service (CRDT) with the States Resources for Testing and Assessments (SRTA).

CHAPTER 104. CONTINUING EDUCATION
22 TAC §104.2

OVERVIEW

The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §104.2, pertaining to continuing education providers. The proposed amendment reflects the merger of Central Regional Dental Testing Service (CRDTS) with the States Resources for Testing and Assessments (SRTA).

Amending 22 TAC §114.6, to require applicants to submit a National Practitioner Data Bank self-query report upon initial registration.

CHAPTER 114. EXTENSION OF DUTIES OF AUXILIARY PERSONNEL–DENTAL ASSISTANTS
22 TAC §114.6

OVERVIEW

The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §114.6, pertaining to general qualifications for registration or certification of dental assistants. The proposed amendment requires applicants to submit a National Practitioner Data Bank self-query report upon initial registration. Initial applicants currently submit this report to the Board as part of the licensing application process; this amendment is proposed to reflect the Board’s current process. The proposed amendment also specifies the name of 22 TAC §101.8.

Amending 22 TAC §117.2, to require faculty license holders to submit an employment affidavit form upon renewal of their license.

CHAPTER 117. FACULTY AND STUDENTS IN ACCREDITED DENTAL SCHOOLS
22 TAC §117.2

OVERVIEW

The State Board of Dental Examiners (Board) proposes these amendments to 22 TAC §117.2, pertaining to dental faculty licensure. The proposed amendment: (1) requires that faculty license holders submit an employment affidavit form upon renewal to show that they are still currently employed by their employer school, and (2) corrects a grammatical error.

Amending 22 TAC §117.3, to conform to the statutory language in the Texas Occupations Code, which requires faculty license holders to submit an employment affidavit form upon renewal of their license.

CHAPTER 117. FACULTY AND STUDENTS IN ACCREDITED DENTAL SCHOOLS
22 TAC §117.3

OVERVIEW

The State Board of Dental Examiners (Board) proposes these amendments to 22 TAC §117.3, pertaining to dental hygiene faculty licensure. The proposed amendment: (1) conforms the rule to the statutory language in Texas Occupations Code §267.003, (2) requires that faculty license holders submit an employment affidavit form upon renewal to show that they are still currently employed by their employer school, and (3) corrects grammatical and punctuation errors.

Texas Health and Human Services Commission

Withdrawn Rules Re:

Withdrawing 26 TAC §745.8301, to expand the definition of “kinship foster home”; remove language from the rule for consistency; update terms, and rename the section title.

CHAPTER 745. LICENSING
SUBCHAPTER J. WAIVERS AND VARIANCES FOR MINIMUM STANDARDS
26 TAC §745.8301

OVERVIEW

The Health and Human Services Commission withdraws proposed amendments to §745.8301 which appeared in the June 6, 2025, issue of the Texas Register (50 TexReg 3424).

Withdrawing 26 TAC §749.2472, to delete an unnecessary rule.

CHAPTER 749. MINIMUM STANDARDS FOR CHILD-PLACING AGENCIES
SUBCHAPTER M. FOSTER HOMES: SCREENINGS AND VERIFICATIONS
DIVISION 3. VERIFICATION OF FOSTER HOME
26 TAC §749.2472

OVERVIEW

The Health and Human Services Commission withdraws the proposed repeal of §749.2472 which appeared in the June 6, 2025, issue of the Texas Register (50 TexReg 3425).

Withdrawing 26 TAC §749.4401, §749.4403, to add a new subchapter to establish definitions and the scope of the regulations as applied to kinship homes.

CHAPTER 749. MINIMUM STANDARDS FOR CHILD-PLACING AGENCIES
SUBCHAPTER W. KINSHIP FOSTER HOMES
DIVISION 1. DEFINITIONS AND SCOPE
26 TAC §749.4401, §749.4403

OVERVIEW

The Health and Human Services Commission withdraws proposed new §749.4401 and §749.4403 which appeared in the June 6, 2025, issue of the Texas Register (50 TexReg 3425).

Withdrawing 26 TAC §§749.4421, 749.4423, 749.4425, 749.4427, 749.4429, to define the regulations concerning the training requirements of kinship caregivers.

CHAPTER 749. MINIMUM STANDARDS FOR CHILD-PLACING AGENCIES
SUBCHAPTER W. KINSHIP FOSTER HOMES
DIVISION 2. PRE-VERIFICATION AND ONGOING TRAINING REQUIREMENTS
26 TAC §§749.4421, 749.4423, 749.4425, 749.4427, 749.4429

OVERVIEW

The Health and Human Services Commission withdraws proposed new §§749.4421, 749.4423, 749.4425, 749.4427, and 749.4429 which appeared in the June 6, 2025, issue of the Texas Register (50 TexReg 3425).

Withdrawing 26 TAC §§749.4441, 749.4443, 749.4445, 749.4447, 749.4449, 749.4451, to define the rules governing the admission and placement of kinship foster children.

CHAPTER 749. MINIMUM STANDARDS FOR CHILD-PLACING AGENCIES
SUBCHAPTER W. KINSHIP FOSTER HOMES
DIVISION 3. ADMISSION AND PLACEMENT
26 TAC §§749.4441, 749.4443, 749.4445, 749.4447, 749.4449, 749.4451

OVERVIEW

The Health and Human Services Commission withdraws proposed new §§749.4441, 749.4443, 749.4445, 749.4447, 749.4449, and 749.4451 which appeared in the June 6, 2025, issue of the Texas Register (50 TexReg 3425).

Withdrawing 26 TAC §§749.4461, 749.4463, 749.4465, to define the rules related to the medical and dental requirements for kinship foster children.

CHAPTER 749. MINIMUM STANDARDS FOR CHILD-PLACING AGENCIES
SUBCHAPTER W. KINSHIP FOSTER HOMES
DIVISION 4. MEDICAL AND DENTAL REQUIREMENTS
26 TAC §§749.4461, 749.4463, 749.4465

OVERVIEW

The Health and Human Services Commission withdraws proposed new 26 TAC §§749.4461, 749.4463 and 749.4465 which appeared in the June 6, 2025, issue of the Texas Register (50 TexReg 3425).

Withdrawing 26 TAC §§749.4471, 749.4473, 749.4475, 749.4477, 749.4479, 749.4481, 749.4483, 749.4485, 749.4487, 749.4489, 749.4491, 749.4493, to define the rules concerning the daily care, education, and discipline of kinship foster children.

CHAPTER 749. MINIMUM STANDARDS FOR CHILD-PLACING AGENCIES
SUBCHAPTER W. KINSHIP FOSTER HOMES
DIVISION 5. DAILY CARE, EDUCATION, AND DISCIPLINE
26 TAC §§749.4471, 749.4473, 749.4475, 749.4477, 749.4479, 749.4481, 749.4483, 749.4485, 749.4487, 749.4489, 749.4491, 749.4493

OVERVIEW

The Health and Human Services Commission withdraws proposed new §§749.4471, 749.4473, 749.4475, 749.4477, 749.4479, 749.4481, 749.4483, 749.4485, 749.4487, 749.4489, 749.4491, and 749.4493 which appeared in the June 6, 2025, issue of the Texas Register (50 TexReg 3425).

Withdrawing 26 TAC §§749.4501, 749.4503, 749.4505, 749.4507, 749.4509, 749.4511, 749.4513, 749.4515, 749.4517, 749.4519, 749.4521, 749.4523, to set forth the requirements of kinship home screenings and the verification of kinship foster homes.

CHAPTER 749. MINIMUM STANDARDS FOR CHILD-PLACING AGENCIES
SUBCHAPTER W. KINSHIP FOSTER HOMES
DIVISION 6. SCREENINGS AND VERIFICATIONS
26 TAC §§749.4501, 749.4503, 749.4505, 749.4507, 749.4509, 749.4511, 749.4513, 749.4515, 749.4517, 749.4519, 749.4521, 749.4523

OVERVIEW

The Health and Human Services Commission withdraws proposed new §§749.4501, 749.4503, 749.4505, 749.4507, 749.4509, 749.4511, 749.4513, 749.4515, 749.4517, 749.4519, 749.4521, and 749.4523 which appeared in the June 6, 2025, issue of the Texas Register (50 TexReg 3425).

Withdrawing 26 TAC §§749.4551, 749.4553, 749.4555, 749.4557, 749.4559, 749.4561, 749.4563, 749.4565, 749.4567, 749.4569, 749.4571, 749.4573, 749.4575, 749.4577, 749.4579, 749.4581, to set dictate the rules related to health and safety, environment, space, and equipment in kinship foster homes.

CHAPTER 749. MINIMUM STANDARDS FOR CHILD-PLACING AGENCIES
SUBCHAPTER W. KINSHIP FOSTER HOMES
DIVISION 7. HEALTH AND SAFETY REQUIREMENTS, ENVIRONMENT, SPACE, AND EQUIPMENT
26 TAC §§749.4551, 749.4553, 749.4555, 749.4557, 749.4559, 749.4561, 749.4563, 749.4565, 749.4567, 749.4569, 749.4571, 749.4573, 749.4575, 749.4577, 749.4579, 749.4581

OVERVIEW

The Health and Human Services Commission withdraws proposed new §§749.4551, 749.4553, 749.4555, 749.4557, 749.4559, 749.4561, 749.4563, 749.4565, 749.4567, 749.4569, 749.4571, 749.4573, 749.4575, 749.4577, 749.4579, and 749.4581 which appeared in the June 6, 2025, issue of the Texas Register (50 TexReg 3425).

Adopted Rules Re:

Adopting 1 TAC §§355.502, 355.505, 355.513, to clarify the types of services included under the umbrella of professional services under §1915(c) waiver programs and correct formatting, references, and punctuation.

CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER E. COMMUNITY CARE FOR AGED AND DISABLED
1 TAC §§355.502, 355.505, 355.513

OVERVIEW

The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §355.502, concerning Reimbursement Methodology for Common Services in Home and Community-Based Services Waivers; §355.505, concerning Reimbursement Methodology for the Community Living Assistance and Support Services Waiver Program; §355.513, concerning Reimbursement Methodology for the Deaf-Blind with Multiple Disabilities Waiver Program; §355.723, concerning Reimbursement Methodology for Home and Community-Based Services and Texas Home Living Programs; and §355.725, concerning Reimbursement Methodology for Common Waiver Services in Home and Community-based Services (HCS) and Texas Home Living (TxHmL).

BACKGROUND AND JUSTIFICATION

The amendments are necessary to add in-home and out-of-home settings for home health care services (including nursing, occupational therapy, and physical therapy) to the reimbursement methodologies for Community Living Assistance and Support Services Waiver Program (CLASS), the Deaf-blind Multiple Disabilities (DBMD), Home and Community-based Services (HCS), and Texas Home Living (TxHmL) waiver programs. These amendments ensure compliance with the 21st Century Cures Act, which requires all states to implement the use of electronic visit verification (EVV).

The amendments also establish the reimbursement methodology for employment readiness services in the DBMD, HCS, and TxHmL waiver programs in accordance with House Bill 4169, 88th Legislature, Regular Session, 2023.

SECTION-BY-SECTION SUMMARY

Sections 355.505, 355.513, and 355.725 are adopted with changes to the proposed text as published in the January 24, 2025, issue of the Texas Register (50 TexReg 513). These rules will be republished.

Adopting 1 TAC §355.723, §355.725, to clarify that certain services are offered in both in-home and out-of-home settings under the HCS and TxHmL programs, as well as common waiver services.

CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER F. REIMBURSEMENT METHODOLOGY FOR PROGRAMS SERVING PERSONS WITH MENTAL ILLNESS OR INTELLECTUAL OR DEVELOPMENTAL DISABILITY
1 TAC §355.723, §355.725

OVERVIEW

The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §355.502, concerning Reimbursement Methodology for Common Services in Home and Community-Based Services Waivers; §355.505, concerning Reimbursement Methodology for the Community Living Assistance and Support Services Waiver Program; §355.513, concerning Reimbursement Methodology for the Deaf-Blind with Multiple Disabilities Waiver Program; §355.723, concerning Reimbursement Methodology for Home and Community-Based Services and Texas Home Living Programs; and §355.725, concerning Reimbursement Methodology for Common Waiver Services in Home and Community-based Services (HCS) and Texas Home Living (TxHmL).

BACKGROUND AND JUSTIFICATION

The amendments are necessary to add in-home and out-of-home settings for home health care services (including nursing, occupational therapy, and physical therapy) to the reimbursement methodologies for Community Living Assistance and Support Services Waiver Program (CLASS), the Deaf-blind Multiple Disabilities (DBMD), Home and Community-based Services (HCS), and Texas Home Living (TxHmL) waiver programs. These amendments ensure compliance with the 21st Century Cures Act, which requires all states to implement the use of electronic visit verification (EVV).

The amendments also establish the reimbursement methodology for employment readiness services in the DBMD, HCS, and TxHmL waiver programs in accordance with House Bill 4169, 88th Legislature, Regular Session, 2023.

SECTION-BY-SECTION SUMMARY

Sections 355.502 and 355.723 are adopted without changes to the proposed text as published in the January 24, 2025, issue of the Texas Register (50 TexReg 513). These rules will not be republished.

Adopted Rule Reviews Re:

Adopting Title 26, Part 1, concerning the Medicaid Hospice Program.

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 266, Medicaid Hospice Program

In Addition Re:

Notice of Public Hearing on Proposed Medicaid Payment Rate Actions for Attendant Services in Community First Choice (CFC), Home and Community-Based Services Adult Mental Health Program (HCBS-AMH), Home and Community-Based Services (HCS), Texas Home Living Waiver (TxHmL), and Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID) Programs, Effective September 1, 2025

Hearing. The Texas Health and Human Services Commission (HHSC) will hold a public hearing on July 16, 2025, from 9:00 a.m. to 10:45 a.m. CDT to receive public comments on the proposed Medicaid payment rates.

Notice of Public Hearing on Proposed Medicaid Payment Rate Actions for Nursing Facilities (NFs) and Nursing Facility Special Reimbursement Class for Individuals with Intellectual and Developmental Disabilities (IIDs), Effective September 1, 2025

Hearing. The Texas Health and Human Services Commission (HHSC) will hold a public hearing on July 16, 2025, from 2:00 to 3:45 p.m. CDT to receive public comments on the proposed Medicaid payment rates.

Notice of Public Hearing on Proposed Medicaid Payment Rate Actions for Nursing Facilities (NFs) and Nursing Facility Special Reimbursement Class for Individuals with Intellectual and Developmental Disabilities (IIDs), Effective September 1, 2025

Hearing. The Texas Health and Human Services Commission (HHSC) will hold a public hearing on July 16, 2025, from 2:00 p.m. to 3:45 p.m. CDT to receive public comments on the proposed Medicaid payment rates.

Public Notice: Community Living Assistance and Support Services (CLASS) Waiver Program

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

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

The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to amend the waiver application for the Community Living Assistance and Support Services (CLASS) waiver program authorized under §1915(c) of the Social Security Act. CMS has approved the CLASS waiver application through August 31, 2029. The proposed effective date for the amendment is September 1, 2025.

Public Notice: Deaf Blind with Multiple Disabilities (DBMD) Waiver Amendment

The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to amend the waiver application for the Deaf Blind with Multiple Disabilities (DBMD) waiver program authorized under §1915(c) of the Social Security Act. CMS has approved the DBMD waiver application through February 29, 2028. The proposed effective date for this amendment is September 1, 2025.

Public Notice: Deaf Blind with Multiple Disabilities (DBMD) Waiver Program Amendment

The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to amend the waiver application for the Deaf Blind with Multiple Disabilities (DBMD) waiver program authorized under §1915(c) of the Social Security Act. CMS has approved the DBMD waiver application through February 29, 2028. The requested effective date for the proposed amendment is September 1, 2025.

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

The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to amend the Home and Community-based Services (HCS) waiver program authorized under §1915(c) of the Social Security Act. CMS has approved the HCS waiver application through August 31, 2028. The proposed effective date for the amendment is September 1, 2025.

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

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

Public Notice: Medically Dependent Children Program (MDCP) Waiver Program Amendment

The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to amend the waiver application for the Medically Dependent Children Program (MDCP) waiver program authorized under the authority of §1915(c) of the Social Security Act. CMS has approved the MDCP waiver application through August 31, 2027.

Public Notice: Texas Home Living (TxHmL) Waiver Amendment

The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to amend the waiver application for the Texas Home Living (TxHmL) waiver program authorized under §1915(c) of the Social Security Act. CMS has approved the TxHmL waiver application through February 28, 2027. The proposed effective date for this amendment is September 1, 2025.

Public Notice: Texas Home Living (TxHmL) Waiver Program Amendment

The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to amend the waiver application for the Texas Home Living (TxHmL) waiver program authorized under §1915(c) of the Social Security Act. CMS has approved the TxHmL waiver application through February 28, 2027. The requested effective date for the proposed amendment is September 1, 2025.

Texas Department of State Health Services

In Addition Re:

Licensing Actions for Radioactive Materials (.pdf)

For more information, please visit this week’s edition of the Texas Register at 50 Tex. Reg. 3679.

Licensing Actions for Radioactive Materials (.pdf)

For more information, please visit this week’s edition of the Texas Register at 50 Tex. Reg. 3683.