Texas Register October 31, 2025 Volume: 50 Number: 44

Texas Register Table of Contents

1 Texas Health and Human Services Commission
2 Texas State Board of Examiners of Professional Counselors
- - 2.0.1 Withdrawn Rules Re:
    - 2.0.1.1 Withdrawing 22 TAC §681.91, to update language concerning LPC Associate practice to be more plain and direct.
    - 2.0.1.2 Withdrawing 22 TAC §681.93, to require an LPC supervisor to document the duration of supervision sessions and the locations at which an Associate will practice as part of their supervision file.
3 Texas Department of State Health Services
- - 3.0.1 In Addition Re:
    - 3.0.1.1 Licensing Actions for Radioactive Materials

Texas Health and Human Services Commission

Proposed Rules Re:

Amending 1 TAC §351.851, to establish an the Interested Parties Advisory Group to advise and consult with HHSC.

CHAPTER 351. COORDINATED PLANNING AND DELIVERY OF HEALTH AND HUMAN SERVICES
SUBCHAPTER B. ADVISORY COMMITTEES
DIVISION 1. COMMITTEES
1 TAC §351.851

OVERVIEW

The executive commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §351.851, concerning Interested Parties Advisory Group.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to comply with 42 Code of Federal Regulations (42 CFR) §447.203(b)(6), which requires HHSC to “establish an advisory group for interested parties to advise and consult on provider rates with respect to service categories under the Medicaid State Plan, 1915(c) waiver, and demonstration programs, as applicable, where payments are made to direct care workers specified in §441.311(e)(1)(ii) for the self-directed or agency-directed services found at §440.180(b)(2) through (4), and (6).”

New §351.851 establishes the Interested Parties Advisory Group (IPAG) to advise and consult with HHSC on current and proposed payment rates, Home and Community Based Services (HCBS) payment adequacy data as required by 42 CFR §441.311(e), and access to care metrics described in 42 CFR §441.311(d)(2), associated with services found in 42 CFR §440.180(b)(2) through (4), and (6).

The IPAG is intended to advise the executive commissioner and HHSC on certain current and proposed Medicaid provider payment rates to ensure the relevant Medicaid payment rates are sufficient to ensure Medicaid beneficiaries access to personal care, home health aide, homemaker, and habilitation services.

SECTION-BY-SECTION SUMMARY

Proposed new §351.851(a) provides the statutory authority for the IPAG.

Proposed new §351.851(b) describes the purpose of the IPAG.

Proposed new §351.851(c) lists the tasks performed by IPAG.

Proposed new §351.851(d) explains the reporting requirements.

Proposed new §351.851(e) describes the meeting requirements.

Proposed new §351.851(f) lists the membership composition and appointment terms.

Proposed new §351.851(g) describes how the chair and vice chair are selected and the terms of office.

Proposed new §351.851(h) explains the required training.

Proposed new §351.851(i) provides the travel reimbursement policy.

Proposed new §351.851(j) provides the abolishment date.

Amending 26 TAC §§321.1, 321.3, 321.5, 321.7, to repeal the sections.

CHAPTER 321. SUBSTANCE USE SERVICES
SUBCHAPTER A. PREVENTION
26 TAC §§321.1, 321.3, 321.5, 321.7

OVERVIEW

The executive commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §321.1, concerning Purpose; §321.3, concerning Application; §321.5, concerning Definitions; and §321.7, concerning Program Description, and new §321.1, concerning Purpose; §321.3, concerning Application; §321.5, concerning Definitions; §321.7, concerning General Program Requirements; §321.9, concerning Program Staffing; and §321.11, concerning Program Service Delivery.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to replace the current rules in Title 26, Texas Administrative Code Chapter 321, Subchapter A relating to Substance Use Prevention, with new rules that clarify provider requirements related to training, staffing, written policies and procedures, screening tools, and other requirements that inform substance use prevention service delivery.

SECTION-BY-SECTION SUMMARY

The proposed repeal of §321.1 deletes the rule as no longer necessary, because the content of the rule is outdated.

The proposed repeal of §321.3 deletes the rule as no longer necessary, because the content of the rule is outdated.

The proposed repeal of §321.5 deletes the rule as no longer necessary, because proposed new §321.5 contains the definitions used in the proposed new rules.

The proposed repeal of §321.7 deletes the rule because the content of the rule has been added to proposed new rule §321.11.

Amending 26 TAC §§321.1, 321.3, 321.5, 321.7, 321.9, 321.11, to replace the current rules with new rules that clarify provider requirements related to training, staffing, written policies and procedures, screening tools, and other requirements that inform substance use prevention service delivery.

CHAPTER 321. SUBSTANCE USE SERVICES
SUBCHAPTER A. PREVENTION
26 TAC §§321.1, 321.3, 321.5, 321.7, 321.9, 321.11

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

Proposed new §321.1 describes the requirements for substance use prevention services providers to implement the primary prevention strategies.

Proposed new §321.3 clarifies that the rules apply to HHSC providers delivering substance use prevention services.

Proposed new §321.5 contains key terms and their definitions needed to align with the proposed new rules.

Proposed new §321.7 describes provider requirements and the prevention strategies that providers must implement. The proposed new rules clarify provider responsibilities when implementing substance use services including the need for formal agreements, operating in accordance with required policies and procedures, and the ability to screen for additional services.

Proposed new §321.9 sets standards for providers regarding sufficient staffing levels and certification requirements for staff.

Proposed new §321.11 describes prevention program service delivery requirements for each of the five prevention program types: universal prevention programs, selective prevention programs, indicated prevention programs, community coalition partnership programs, and prevention resource centers.

Withdrawn Rules Re:

Withdrawing 26 TAC §749.4465, to establish documentation requirements related to medical and dental care, general medical, dental, and medication requirements, and requirements for immunizations and tuberculosis testing 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 §749.4465

OVERVIEW

The Health and Human Services Commission withdraws proposed new §749.4465 which appeared in the July 11, 2025, issue of the Texas Register (50 TexReg 3996).

Adopted Rules Re:

Adopting 26 TAC §745.8301, to expand the definition of kinship foster home, update language, and rename the section.

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

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts an amendment to §745.8301, concerning What words must I know to understand this subchapter, in Title 26, Texas Administrative Code, Chapter 745, Licensing.

The amendment to §745.8301 is adopted without changes to the proposed text as published in the July 11, 2025, issue of the Texas Register (50 TexReg 3994). The rule will not be republished.

BACKGROUND AND JUSTIFICATION

The amendment is necessary to implement House Bill (HB) 1, 88th Legislature, Regular Session, 2023, which required Child Care Regulation (CCR) to collaborate with the Department of Family and Protective Services (DFPS) to develop and adopt a set of licensing and approval standards for kinship foster homes pursuant to the adoption of federal rules. The Administration for Children and Families amended 45 Code of Federal Regulations (CFR) Parts 1355 and 1356, with the amendments effective on November 27, 2023. These amendments allowed CCR to adopt a set of licensing or approval standards for all kinship foster homes that (1) were different from the standards used for non-kinship foster homes, and (2) allowed a child-placing agency (CPA) to issue a foster home verification to a kinship foster home that meets the new standards. The new standards reduce unnecessary and unreasonable burdens on kinship caregivers to encourage more kinship caregivers to pursue the verification process.

The amendment to §745.8301 also implements recommendations from the Texas HHSC & DFPS Independent Assessment of Residential Child Care Rules, Standards, and Requirements (SB 593) Report to streamline minimum standards and adopt separate verification standards for relative and kinship foster family homes.

The amendment to §745.8301(3) revises the definition of “kinship foster home” to be consistent with the term used in CCR and DFPS rules.

Adopting 26 TAC §749.2472, to delete the rule as it is no longer necessary.

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 Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts new §§749.4401, 749.4403, 749.4421, 749.4423, 749.4425, 749.4427, 749.4429, 749.4441, 749.4443, 749.4445, 479.4447, 479.4449, 749.4451, 749.4461, 749.4463, 749.4471, 749.4473, 749.4475, 749.4477, 749.4479, 749.4481, 749.4483, 749.4485, 749.4487, 749.4489, 749.4491, 749.4493, 749.4501, 749.4503, 749.4505, 749.4507, 749.4509, 749.4511, 749.4513, 749.4515, 749.4517, 749.4519, 749.4521, 749.4523, 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; and the repeal of §749.2472 in Texas Administrative Code, Title 26, Chapter 749, Minimum Standards for Child-Placing Agencies.

New §§749.4425, 749.4427, 749.4461, 749.4463, 749.4477, 749.4479, 749.4507, 749.4553, 749.4569, 749.4571, and 749.4577 are adopted with changes to the proposed text as published in the July 11, 2025, issue of the Texas Register (50 TexReg 3996). These rules will be republished. HHSC withdraws proposed new §749.4465.

New §§749.4401, 749.4403, 749.4421, 749.4423, 749.4429, 749.4441, 749.4443, 749.4445, 749.4447, 749.4449, 749.4451, 749.4471, 749.4473, 749.4475, 749.4481, 749.4483, 749.4485, 749.4487, 749.4489, 749.4491, 749.4493, 749.4501, 749.4503, 749.4505, 749.4509, 749.4511, 749.4513, 749.4515, 749.4517, 749.4519, 749.4521, 749.4523, 749.4551, 749.4555, 749.4557, 749.4559, 749.4561, 749.4563, 749.4565, 749.4567, 749.4573, 749.4575, 749.4579, and 749.4581; and the repeal of §749.2472 are adopted without changes to the proposed text as published in the July 11, 2025 issue of the Texas Register (50 TexReg 3996). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The new sections and repeals are necessary to implement House Bill (HB) 1, 88th Legislature, Regular Session, 2023, which required Child Care Regulation (CCR) to collaborate with the Department of Family and Protective Services (DFPS) to develop and adopt a set of licensing and approval standards for kinship foster homes pursuant to the adoption of federal rules. The Administration for Children and Families amended 45 Code of Federal Regulations (CFR) Parts 1355 and 1356, with the amendments effective on November 27, 2023. These amendments allow CCR to adopt a set of licensing or approval standards for all kinship foster homes that (1) were different from the standards used for non-kinship foster homes, and (2) allowed a child-placing agency (CPA) to issue a foster home verification to a kinship foster home that meets the new standards. The new standards reduce unnecessary and unreasonable burdens on kinship caregivers to encourage more kinship caregivers to pursue the verification process.

The new rules also implement recommendations from the Texas HHSC & DFPS Independent Assessment of Residential Child Care Rules, Standards, and Requirements (SB 593) Report to streamline minimum standards and adopt separate verification standards for relative and kinship foster family homes.