8 Jun 2026

Texas Register June 5, 2026 Volume: 51 Number: 23

by | posted in: Cancer Prevention and Research Institute of Texas, Governor, Texas Department of State Health Services, Texas Health and Human Services Commission, Texas Optometry Board, Texas State Board of Pharmacy |

Texas Register Table of Contents

The Governor

Appointments Re:

Appointed to the Chronic Kidney Disease Task Force for a term to expire at the pleasure of the Governor, Christine Burgess Morris, M.D. of Leander, Texas (replacing Navid Saigal of San Antonio who resigned).
Appointed to the Chronic Kidney Disease Task Force for a term to expire at the pleasure of the Governor, Ajay K. Israni, M.D. of Friendswood, Texas (replacing Francis H. Wright, Jr. M.D. of Marfa who resigned).
Appointed to the Chronic Kidney Disease Task Force for a term to expire at the pleasure of the Governor, Matthew T. “Matt” Smith, M.D. of Frisco, Texas (replacing Leslie A. Weisberg, M.D. of Dallas who resigned).
Appointed to the Chronic Kidney Disease Task Force for a term to expire at the pleasure of the Governor, Donald E. “Don” Wesson, M.D. of Dallas, Texas (replacing Mary E. Albin of Mansfield).
Appointed to the Pediatric Acute-Onset Neuropsychiatric Syndrome Advisory Council for a term to expire August 31, 2027, Amber Felps Cardenas of Burnet, Texas (replacing Sarah Rosen Garrett of Spicewood who resigned).
Appointed to the Advisory Council on Emergency Medical Services for a term to expire January 1, 2032, Trevor J. Stokes of Liberty Hill, Texas (replacing Michael S. “Mike” Clements of Cypress whose term expired).
Appointed to the Texas Pharmaceutical Initiative Governing Board for a term to expire February 1, 2031, Jay S. Bueche of New Braunfels, Texas (replacing Golinda Erowele, Pharm.D. of Missouri City who resigned).

Texas Optometry Board

Proposed Rules Re:

Repealing 22 TAC §271.8 and amending 22 TAC §271.12, to eliminate an unnecessary mechanism for converting optometrist licenses to therapeutic optometrist licenses and to remove provisions in the license designation rule that restate existing statute concerning license display and replacement.

CHAPTER 271. EXAMINATIONS
22 TAC §271.8, §271.12

BACKGROUND AND JUSTIFICATION

The Texas Optometry Board proposes to repeal 22 TAC Part 14 Chapter 271 Examinations – §271.8 – Converting Optometric License to Therapeutic Optometric License.

In 2025, the Texas Legislature created the Texas Regulatory Efficiency Office (TREO) to review state agency rules and procedures to reduce regulatory burdens; eliminate waste, fraud, and unnecessary rules; and increase transparency for Texas taxpayers. In conjunction with the TREO review, the Board is proposing the repeal of §271.8.

Section 271.8 currently provides a mechanism for optometrists to transition their optometrist license to a therapeutic optometrist license. This mechanism was established in 1992 after statute was changed during the 1991 legislative session to provide for a therapeutic license in Texas. In 2026, there are approximately 100 licensees who have the optometrist designation – they are older optometrists and most will be retiring in the next decade.

If any of the 100 optometrists decided to upgrade the license to therapeutic, the Board would work with them to ensure competency is met. Given the number of licensees and the ability of the Board to verify competency, the rule is unnecessary and should be repealed.

The Texas Optometry Board proposes amendments to 22 TAC Part 14 Chapter 271 Examinations – §271.12 – License Designation.

In 2025, the Texas Legislature created the Texas Regulatory Efficiency Office (TREO) to review state agency rules and procedures to reduce regulatory burdens; eliminate waste, fraud, and unnecessary rules; and increase transparency for Texas taxpayers. In conjunction with the TREO review, the Board proposes to amend §271.12 – License Designation to remove sections of the rule that only restate statute.

Subsection (c) restates Texas Occupations Code §351.261 – Display of License or Certificate. Subsection (d) restates Texas Occupations Code §351.263 – Lost or Destroyed License. By eliminating the sections of the rules that restate statute, the agency is reducing the regulatory burden and increasing transparency for licensees.

Repealing 22 TAC §272.4, to eliminate a rule concerning public participation in Board meetings that restates statutory requirements and that the Board will replace with a publicly available policy.

CHAPTER 272. ADMINISTRATION
22 TAC §272.4

BACKGROUND AND JUSTIFICATION

The Texas Optometry Board proposes to repeal 22 TAC Part 14 Chapter 272 Administration – §272.4 – Public Participation in Meetings.

In 2025, the Texas Legislature created the Texas Regulatory Efficiency Office (TREO) to review state agency rules and procedures to reduce regulatory burdens; eliminate waste, fraud, and unnecessary rules; and increase transparency for Texas taxpayers. In conjunction with the TREO review, the Board is proposing the repeal of §272.4.

This rule is derived from Texas Occupations Code 351.202 which requires the Board to “develop and implement policies that provide the public with a reasonable opportunity to appear before the board and to speak on any issue under the board’s jurisdiction.”

In conjunction with the repeal of this rule, the Board will adopt a policy regarding public participation at meetings. The policy will be available on the Board’s public facing website for public review.

Repealing 22 TAC §273.1 and §273.10, to eliminate unnecessary rules concerning license surrender upon nonrenewal and nonrenewal for failure to pay child support, which either restate existing statute or have been made unnecessary by other available mechanisms.

CHAPTER 273. GENERAL RULES
22 TAC §273.1, §273.10

BACKGROUND AND JUSTIFICATION

The Texas Optometry Board proposes to repeal 22 TAC Part 14 Chapter 273 General Rules – §273.1 – Surrender of License.

In 2025, the Texas Legislature created the Texas Regulatory Efficiency Office (TREO) to review state agency rules and procedures to reduce regulatory burdens; eliminate waste, fraud, and unnecessary rules; and increase transparency for Texas taxpayers. In conjunction with the TREO review, the Board is proposing the repeal of §273.1.

Section 273.1 was adopted in 1984 – the Board’s purpose was to ensure that optometrists who do not renew a license would not be in possession of a valid license and therefore could not practice optometry. By requiring the return of the license and/or an affidavit stating the optometrist would not practice, the Board was protecting the health and welfare of the general public.

However, online searches of the Board’s licensees now provide a way for members of the public to verify that a person has a valid therapeutic license. As such, this rule is an unnecessary step for licensees and an unnecessary burden for staff to maintain the affidavits. The Board has other disciplinary tools for those licensees who practice without a license.

The Texas Optometry Board proposes to repeal 22 TAC Part 14 Chapter 273 General Rules – §273.10 – Nonrenewal for Failure to Pay Child Support.

In 2025, the Texas Legislature created the Texas Regulatory Efficiency Office (TREO) to review state agency rules and procedures to reduce regulatory burdens; eliminate waste, fraud, and unnecessary rules; and increase transparency for Texas taxpayers. In conjunction with the TREO review, the Board is proposing the repeal of §273.10.

This rule is derived from the Family Code §232.0135 which directs the Board to hold license renewals for non-payment of child support. This rule is unnecessary as it simply restates the statute related to child support payments. The Board has full authority to withhold a license renewal based on the statute.

Texas Department of State Health Services

Proposed Rules Re:

Amending 25 TAC §227.1, to update the minimum guidelines for human donor milk banks by adopting current Human Milk Banking Association of North America standards, updating how guidelines are publicly accessed, and adding a requirement that donor milk banks ensure donated milk is safe and properly labeled.

CHAPTER 227. MINIMUM GUIDELINES FOR HUMAN DONOR MILK BANKS
25 TAC §227.1

BACKGROUND AND PURPOSE

The proposal is necessary to comply with Texas Health and Safety Code (HSC) §161.071, which requires DSHS to establish minimum guidelines for the procurement, processing, distribution, or use of human milk by donor milk banks. DSHS uses Human Milk Banking Association of North America (HMBANA) standards to determine minimum Texas donor human milk bank guidelines. The proposed rule amendment updates outdated HMBANA guidelines.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §227.1 updates the publication used to establish standards for milk banking, updates how guidelines are publicly accessed, and adds language that human donor milk banks must ensure donated milk is safe and properly labeled in accordance with HMBANA guidelines.

Cancer Prevention and Research Institute of Texas

Proposed Rules Re:

Amending 25 TAC §703.23, to clarify that all Product Development Research Grant Recipients are subject to a ten percent holdback of total grant award funds regardless of whether they receive funds by advance payment or reimbursement, and to allow any grant recipient subject to the holdback to request a reduction of the withheld amount.

CHAPTER 703. GRANTS FOR CANCER PREVENTION AND RESEARCH
25 TAC §703.23

BACKGROUND INFORMATION AND JUSTIFICATION

CPRIT may withhold the last ten percent (10%) of the total Grant Award funds from a Grant Recipient that receives Grant Award funds via advance payment. Pursuant to §703.23(a), the Grant Recipient must successfully complete all close out reports required by the Institute to receive the withheld funds. This functions to ensure the Grant Recipient’s required compliance with all Grant Award close out documents.

Grant Recipients under the Product Development Research Program have sought and received advance Grant Award funds. As a result, CPRIT does not disburse the last ten percent (10%) of Grant Award funds for most Product Development Research Grant Recipients until the Grant Recipients have submitted close out documents.

Some Product Development Research Grant Recipients that initially received Grant Award funds paid in advance voluntarily elected to receive Grant Award funds via reimbursement-based disbursement during their Grant Contract term. Rule §703.23 does not provide clear guidance regarding the Institute’s ability to withhold the final ten percent (10%) of Grant Award funds when the Grant Recipient has received advanced payment of Grant Award funds in the past but has later shifted to receiving payment of Grant Award funds on a reimbursement basis. The proposed rule change to §703.23 clarifies that all Product Development Research Grant Recipients are subject to the ten percent (10%) holdback regardless of whether they receive Grant Award funds in advance or on a reimbursement basis. All other Grant Recipients may be subject to the ten percent (10%) holdback if the Institute determines it is necessary and provides notice no later than the first day of the final Financial Status Report period for the Grant Award.

The proposed rule change permits the Grant Recipient subject to the ten percent (10%) holdback to submit a written request to CPRIT’s Chief Executive Officer to reduce or eliminate the amount of Grant Award funds otherwise withheld by the Institute. A Grant Recipient’s request must include a reasonable justification of the circumstances supporting a reduced holdback. Because this rule revision codifies the most common practice and applies it to all circumstances easily, it will avoid ambiguity and complexity in the application of the rule with little to no change to current practices.

SECTION-BY-SECTION SUMMARY

Proposed §703.23(a) ensures the consistent use of defined terms and removes text related to the withholding of final Grant Award funds. The Institute proposes moving the requirement to §703.23(c) and providing more explanation of how and when the Institute will withhold final Grant Award fund payment.

Proposed §703.23(c) explains when the Institute will withhold the final ten percent (10%) of Grant Funds from a Grant Recipient, when the Institute will release final Grant Award funds to a Grant Recipient, how a Grant Recipient may request the Institute withhold less than ten percent (10%), and that the Chief Executive Officer makes the final determination and notifies the Oversight Committee.

Texas State Board of Pharmacy

Withdrawn Rules Re:

Withdrawing 22 TAC §291.13, to withdraw a proposed new rule concerning all classes of pharmacies.

CHAPTER 291. PHARMACIES
SUBCHAPTER A. ALL CLASSES OF PHARMACIES
22 TAC §291.13

OVERVIEW

The Texas State Board of Pharmacy withdraws proposed new §291.13 which appeared in the March 27, 2026, issue of the Texas Register (51 TexReg 1963).

Texas Health and Human Services Commission

In Addition Re:

Criminal History Requirements for Child Care Operations

26 Texas Administrative Code §745.661 (relating to What types of criminal convictions may affect a subject’s ability to be present at an operation?) states that HHSC will review the three charts listed in subsection (a) of the section annually and publish any changes for public comment in the Texas Register as an “In Addition” document. Questions or comments about the content of the proposed changes may be directed to Child Care Regulation at (512) 438-3269.

Written comments may be submitted by email to CCRRules@hhs.texas.gov or mailed to:

Child Care Regulation, Health and Human Services Commission
P.O. Box 149030
Mail Code E550
Austin, Texas 78751

Any comments must be received within 30 days of publication in the Texas Register.

The three charts are titled: (1) Licensed or Certified Child Care Operations: Criminal History Requirements; (2) Foster or Adoptive Placements: Criminal History Requirements; and (3) Registered Child Care Homes and Listed Family Homes: Criminal History Requirements.

Each chart has three parts: (1) an introduction that identifies the types of operations each chart covers, defines certain terms used in the chart, and clarifies certain assumptions; (2) a Table of Contents; and (3) the applicable chart.

Changes made to the charts include:

(1) Adding Texas Penal Code §32.45, Misapplication of Fiduciary Property or Property of Financial Institution, in all three charts;

(2) Adding Texas Penal Code §32.56, Financial Abuse Using Artificially Generated Media or Phishing, in all three charts;

(3) Adding Texas Penal Code §43.235, Possession, Promotion, or Production of Certain Visual Material Appearing to Depict Child, in all three charts;

(4) Updating responses for the felony level offense and the misdemeanor offense to Texas Penal Code §48.02, Prohibition of the Purchase and Sale of Human Organs, in all three charts;

(5) Updating responses for the misdemeanor offense to Texas Penal Code §48.03, Prohibition on Purchase and Sale of Human Fetal Tissue, in the Licensed or Certified Child Care Operations and Registered Child Care Homes and Listed Family Homes charts; and

(6) Making nonsubstantive changes that do not affect the outcome of background checks or the assumptions that apply to the charts.

Public Notice: Medicaid Estate Recovery Program (MERP)

Public Notice: This amendment aligns the State Plan with the Medicaid Estate Recovery Program (MERP) Texas Administrative Code (TAC) Title 1, Part 15, Chapter 373, Medicaid Estate Recovery Program.

The Texas Health and Human Services Commission (HHSC) announces its intent to submit amendments to the Texas State Plan for Medical Assistance under Title XIX of the Social Security Act. The proposed amendment is effective July 2, 2026.

The purpose of this amendment is to align the State Plan with the MERP TAC Title 1, Part 15, Chapter 373, Medicaid Estate Recovery Program, Subchapter A, General; Subchapter B, Recovery Claims; and Subchapter C, Notice.

The proposed amendment is necessary to implement and administer the MERP to recover the costs of Medicaid long-term care (LTC) benefits received by certain Medicaid recipients.

This proposed amendment clarifies MERP eligibility requirements to ensure proper recovery of Medicaid long-term care costs, updates outdated terminology and citations, increases the minimum amount of an estate subject to recovery under MERP, and cleans up language throughout for consistency.

The proposed amendment is estimated to have no fiscal impact.

To obtain copies of the proposed amendment, interested parties may contact Jayasree Sankaran, State Plan Coordinator, by mail at the Health and Human Services Commission, P.O. Box 13247, Mail Code H-600, Austin, Texas 78711; by telephone at (512) 438-4331; or by email at Medicaid_Chip_SPA_Inquiries@hhsc.state.tx.us.