Texas Register September 19, 2025 Volume: 50 Number: 38

Texas Register Table of Contents

1 Texas Health and Human Services Commission
2 Texas Animal Health Commission
- - 2.0.1 Proposed Rules Re:
3 Texas Board of Nursing
- - 3.0.1 Proposed Rules Re:
4 Texas Department of State Health Services
- - 4.0.1 Proposed Rules Re:

Texas Health and Human Services Commission

Proposed Rules Re:

Amending 1 TAC §351.3, §351.6, to update the title and language, as well as allow for the issuance of a provisional license to be issued to any military service member or a military spouse who submits an application and meets the necessary requirements.

CHAPTER 351. COORDINATED PLANNING AND DELIVERY OF HEALTH AND HUMAN SERVICES
SUBCHAPTER A. GENERAL PROVISIONS
1 TAC §351.3, §351.6

OVERVIEW

The executive commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §351.3, concerning Recognition of Out-of-State License of Military Service Members and Military Spouses and §351.6, concerning Alternative Licensing for Military Service Members, Military Spouses, and Military Veterans.

BACKGROUND AND JUSTIFICATION

The proposal is necessary to comply with House Bill (H.B.) 5629, 89th Regular Session, 2025 and Senate Bill (S.B.) 1818, 89th Regular Session, 2025.

S.B. 1818 amends Texas Occupation Code (TOC) §55.004 and §55.0041 to allow a military service member, a military veteran, or a military spouse to receive a provisional license upon receipt of a complete application, if they meet the existing criteria outlined in TOC §55.004 or §55.004. To qualify, the applicant must hold a current license in good standing from another state that is similar in scope of practice to a license issued in Texas.

H.B. 5629 amends TOC §55.004 and §55.0041 to require state agencies to recognize out-of-state licenses that are in good standing and similar in scope of practice to a Texas license, and to issue a corresponding Texas license. The bill also changes the documentation required in an application, shortens the time by which the agency must process an application, and defines “good standing”.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §351.3 updates the title of the section to “Recognition of Out-of-State License of a Military Service Member or Military Spouse.” The proposed amendment also allows a provisional license to be issued to any military service member or a military spouse who submits an application and meets the requirements as outlined in TOC §55.004 and §55.0041. The proposed amendment revises language for clarity, consistency, plain language, and style.

The proposed amendment to §351.6 allows a provisional license to be issued to any military service member, military veteran, or a military spouse who submits an application and meets the requirements as outlined in TOC §55.004 and §55.0041. The proposed amendment also revises language for clarity, consistency, plain language, and style.

Amending 26 TAC §744.3409, to update the rule title and language as well as add an option to provide a PFD with a buoyancy level of 70 or above.

CHAPTER 744. MINIMUM STANDARDS FOR SCHOOL-AGE AND BEFORE OR AFTER-SCHOOL PROGRAMS
SUBCHAPTER O. SWIMMING POOLS, WADING/SPLASHING POOLS, AND SPRINKLER PLAY
26 TAC §744.3409

OVERVIEW

The executive commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §744.3409, concerning What additional safety precautions must I take for a child in care who is unable to swim competently or who is at risk of injury or death when swimming?

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to update current rule language related to United States Coast Guard approved personal flotation devices (PFDs) to reflect changes to buoyancy labeling.

HHSC Child Care Regulation (CCR) is proposing an amendment to add an option to a rule that requires an operation to provide a child who accesses a swimming pool with a United States Coast Guard approved PFD that has a rating of Type I, II, or III, or a buoyancy level of 70 or above.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §744.3409 (1) updates the rule title; (2) replaces a pronoun with a noun; and (3) adds an option to provide a PFD with a buoyancy level of 70 or above to the requirement that an operation provide certain children with a Type I, II, or III, United States Coast Guard approved PFD.

Adopted Rules Re:

Adopting 1 TAC §355.312, to clarify the calculation methodology for liability insurance add-on rates for nursing facility providers.

CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER C. REIMBURSEMENT METHODOLOGY FOR NURSING FACILITIES
1 TAC §355.312

OVERVIEW

The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts an amendment to §355.312, concerning Reimbursement Setting Methodology–Liability Insurance Costs.

Section 355.312 is adopted without changes to the proposed text as published in the May 16, 2025, issue of the Texas Register (50 TexReg 2883). This section will not be republished.

BACKGROUND AND JUSTIFICATION

The amendment is necessary to revise the methodology for liability insurance add-on rates for nursing facility providers. The amendment clarifies HHSC will pay the same add-on rate for providers who purchase general liability insurance without professional liability insurance, providers who purchase professional liability insurance without general liability insurance, and providers who purchase both general and professional liability insurance. This change ensures that HHSC is applying the appropriation uniformly across all nursing facility providers that carry liability insurance.

In Addition Re:

Notice of Provider Engagement Meetings for Medicaid Payment Rates

The Texas Health and Human Services Commission (HHSC) Provider Finance Department (PFD) will hold a provider engagement meeting on September 25, 2025, to receive comments on Medicaid payment rate topics that may be addressed at the upcoming November 2025 rate hearings. Commentary will be collected solely on the topics listed in this notice. Proposed rates will not be published at this time.

Public Notice: Superior Waiver Not Renewed

The Texas Health and Human Services Commission (HHSC) announces its intent to submit transmittal number 25-0032 to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act.

The purpose of this amendment is to acknowledge that, as of September 1, 2025, HHSC will no longer have a Superior Waiver in place under 42 CFR Part 456, Subpart H, that waives the requirements of Subpart C for all hospitals and all mental hospitals for a state that sufficiently demonstrates utilization review procedures that are superior to the federal requirements.

Texas Animal Health Commission

Proposed Rules Re:

Amending 4 TAC §§38.1 – 38.3, 38.8, to correct and update test result language and certain testing requirements regarding the Trichomoniasis program.

CHAPTER 38. TRICHOMONIASIS
4 TAC §§38.1 – 38.3, 38.8

OVERVIEW

The Texas Animal Health Commission (Commission) proposes amendments to Title 4, Texas Administrative Code, Chapter 38 titled “Trichomoniasis.” Specifically, the Commission proposes amendments to §38.1 regarding Definitions, §38.2 regarding General Requirements, §38.3 regarding Infected Herds, and §38.8 regarding Herd Certification Program–Breeding Bull.

BACKGROUND AND JUSTIFICATION

The Commission proposes amendments to Chapter 38 to correct and update test result language and certain testing requirements regarding the Trichomoniasis program.

Bovine Trichomoniasis is a sexually transmitted disease of cattle caused by the organism Trichomonas foetus. The trichomoniasis organism is found on the surface of an infected bull’s penis and on the inside of the prepuce. Once a bull is infected, it is infected for life and is a reservoir for the organism. An infected bull will not show symptoms but will physically transmit the organism to female cattle during the breeding process. Clinical indications of the presence of trichomoniasis in female cattle include reduced pregnancy rates, changes in pregnancy pattern, pyometras and higher rates of abortion throughout the pregnancy.

Unlike bulls, Trichomoniasis infected females will show an immune response to the presence of the Trichomonas foetus organism in their reproductive tract. Antibodies are produced both within the reproductive tract and blood which helps in the clearance of the infection in many exposed females. The immunity is short-lived and cattle that have previously cleared the infection can become re-infected if exposed to the organism during a following breeding. Infected female cattle can remain infected throughout their pregnancy, deliver a live calf and be a potential threat in spreading the disease in the next breeding season.

The Bovine Trichomoniasis Working Group (TWG) met on July 10, 2025, to review the effectiveness of the current program. The TWG discussed the program overview to date and the need for updated rule language and possible revisions to the program’s assurance testing requirements.

The TWG recommended to update rule language that references “negative” test result to “not detected” results. This change reflects the most correct way to report results from a test that does not find a target pathogen because pathogens may not be present or there may merely be insufficient genetic material from the target pathogen such that it was not found above the detection limit of the test.

The second recommendation is to eliminate the assurance testing requirements for bulls that are part of a herd one year after the date the hold order or quarantine on the herd was released. This requirement was originally put in place to address repeat infections. The TWG’s evaluation of this requirement found that the testing has not served that purpose, there is not a need for additional surveillance at this time, and the requirement is administratively burdensome.

As a result of the TWG’s review, the Commission proposes amendments to Chapter 38 to update “negative” test result to “not detected,” and to remove the official testing requirement for bulls that are part of an infected one year after the release of a hold or quarantine order

SECTION-BY-SECTION DISCUSSION

Section 38.1 includes definitions for the Trichomoniasis program. The proposed amendments change “negative” test result to “not detected.”

Section 38.2 outlines the general requirements of the Trichomoniasis program. The proposed amendments update “negative” test result to “not detected.”

Section 38.3 concerns infected herds. The proposed amendments update “negative” test result to “not detected.” Additionally, the proposed amendments eliminate the assurance test requirement for bulls in herds one year after a hold order or quarantine was released. The proposed amendments also adjust numbering.

Section 38.8 includes the Herd Certification Program for breeding bulls. The proposed amendments update “negative” test result to “not detected.” The proposed amendments corrects formatting to italicize scientific names.

Amending 4 TAC §45.3, to add egg drop syndrome virus to the list of reportable and actionable diseases.

CHAPTER 45. REPORTABLE AND ACTIONABLE DISEASES
4 TAC §45.3

OVERVIEW

The Texas Animal Health Commission (Commission) proposes amendments to Title 4, Texas Administrative Code, Chapter 45 titled “Reportable and Actionable Disease List.” Specifically, the Commission proposes amendments to §45.3 to establish and include “egg drop syndrome virus” as a disease that is reportable to the Commission.

BACKGROUND AND JUSTIFICATION

Egg drop syndrome virus (EDSv) is an infectious disease caused by an atadenovirus which can affect many species of poultry and birds. The clinical signs of EDSv are largely associated with egg production. Infected birds produce thin-shelled, soft-shelled, or shell-less eggs, and experience a rapid and extended loss in egg production. Currently, there is no treatment for EDSv and vaccine use is limited.

Due to the economic risks posed by EDSv on the Texas poultry industry, early detection and reporting are critical to prevention. The proposed amendment to 4 TAC §45.3 will add egg drop syndrome virus to the list of diseases that are reportable to the Commission in order to address the emerging threat to susceptible species in Texas.

Filed concurrently with a separate preamble, the Commission also proposes amendments to Section 51.15 concerning entry requirements for poultry that require domestic poultry from EDSv affected states or poultry vaccinated against EDSv to enter Texas for immediate slaughter only with a written request reviewed and approved by the executive director.

SECTION-BY-SECTION DISCUSSION

The proposed amendment to §45.3, Reportable and Actionable Disease List, adds egg drop syndrome virus to the list of reportable and actionable diseases and reorders the list in alphabetical order.

Amending 4 TAC §51.15, to consolidate entry requirements for improvement clarity conciseness; reorganize existing entry requirements into lists; and create new requirements for birds entering Texas from EDSy-affected states.

CHAPTER 51. ENTRY REQUIREMENTS
4 TAC §51.15

OVERVIEW

The Texas Animal Health Commission (Commission) proposes amendments to Title 4, Texas Administrative Code, Chapter 51 titled “Entry Requirements.” Specifically, the Commission proposes amendments to §51.15 regarding Poultry.

BACKGROUND AND JUSTIFICATION

Currently, entry requirements for poultry are located in §51.15 and in §57.11. The proposed amendments move the requirements from §57.11 to §51.15. These changes are proposed to create concise and clear guidelines for entry. Additionally, current rules are written in large paragraph blocks that can be difficult to understand. The proposed amendments seek to break the requirements down into easy to follow lists. The proposed amendments to §51.15 are filed concurrently with proposed amendments to §57.11.

Further, the proposed amendments to §51.15 include new entry requirements for poultry entering from EDSv affected states. The proposed amendments require birds from affected states or birds that have been vaccinated against EDSv to submit a written request prior to entry and obtain authorization from the executive director prior to entry. Egg drop syndrome virus (EDSv) is an infectious disease caused by an atadenovirus which can affect many species of poultry and birds. The disease results in malformed eggs and decreased egg production. Currently, there is no treatment for EDSv. The proposed amendments to §51.15 are filed concurrently with a proposed amendment to §45.3 which adds EDSv to the Commission’s reportable and actionable disease list.

SECTION-BY-SECTION DISCUSSION

Section 51.15 includes entry requirements for poultry. The proposed amendments consolidate entry requirements currently found in §57.11 for clarity and conciseness. The proposed amendments reorganize existing entry requirements into easier to follow lists rather than bulky paragraphs. And the proposed amendments create new requirements for birds entering Texas from EDSv affected states similar to existing requirements for birds entering Texas from Infectious Laryngotracheitis affected states.

Amending 4 TAC §57.11, to remove the interstate movement requirements because it is redundant, renumber paragraphs, and clarify proven available methods of poultry carcass disposal.

CHAPTER 57. POULTRY
4 TAC §57.11

OVERVIEW

The Texas Animal Health Commission (Commission) proposes amendments to Title 4, Texas Administrative Code, Chapter 57 titled “Poultry.” Specifically, the Commission proposes amendments to §57.11 regarding general requirements.

BACKGROUND AND JUSTIFICATION

The Commission is tasked with creating and enforcing entry requirements for livestock, fowl, exotic livestock, and exotic fowl. The Commission proposes amendments to the entry requirements governing poultry to simplify and consolidate rules across chapters. Currently, entry requirements for poultry are located in §51.15 and in §57.11. The proposed amendments move the requirements from §57.11 to §51.15. These changes are proposed to create concise and clear guidelines for entry. The proposed amendments to §57.11 are filed concurrently with proposed amendments to §51.15.

SECTION-BY-SECTION DISCUSSION

The proposed amendment to §57.11, General Requirements, remove the interstate movement requirements that have been moved to §51.15, renumber paragraphs, and clarify proven available methods of poultry carcass disposal.

Texas Board of Nursing

Proposed Rules Re:

Amending 22 TAC §217.5, §217.9, to implement a new “similar in scope of practice” standard for licensing requirements and provide that a nurse may now change their licensure status by submitting the nurse license deactivation from through the Texas Nurse Portal.

CHAPTER 217. LICENSURE, PEER ASSISTANCE AND PRACTICE
22 TAC §217.5, §217.9

OVERVIEW

The Texas Board of Nursing (Board) proposes amendments to 22 Texas Administrative Code §217.5, relating to Temporary License and Endorsement, and §217.9, relating to Inactive and Retired Status. The amendments are being proposed under the authority of Texas Occupations Code §301.151 and House Bill 5629, effective September 1, 2025.

BACKGROUND AND JUSTIFICATION

In 2019, the Texas Legislature enacted S.B. 1200 which created Texas Occupations Code §55.0041 to recognize out-of-state occupational licenses for a spouse of a military service member. This allows the portability of a license for the spouse of a service member, so the spouse does not have to redo any curriculum and testing from one state to another when the service member changes duty station. In 2021, during the 87th Regular Legislative Session, the Legislature enacted H.B. 139 that further amended Texas Occupations Code §55.0041, requiring a state agency that issues a license with a residency requirement for license eligibility to adopt rules regarding the documentation necessary for a military spouse applicant to establish residency; allowing the provision to the agency of a copy of the permanent change of station order for the military service member to whom the spouse is married.

During the 88th Legislative Session, S.B. 422 was enacted, which amended §55.0041 and extended this occupational licensing reciprocity to military members who often must station in states outside of where they originally obtained their license, but who still wish to provide valuable services, such as nursing, that are experiencing workforce shortages.

H.B. 5629, enacted during the 89th Regular Legislative Session, has again amended §55.004 and §55.0041. The bill revises the criteria that must be met in order to apply for licensure pursuant to §55.004, requiring that the military service member or spouse hold a current license issued by another state that is similar in scope of practice to the license in this State and that the applicant remains in good standing with that state’s licensing authority. The revised law further specifies the required contents of a license application that is submitted pursuant to §55.0041, including a copy of the applicant’s military orders showing relation to this state, a copy of a military spouse’s marriage license, and a notarized affidavit. Additionally, H.B. 5629 requires that state agencies respond to applications for licensure submitted by service members or spouses pursuant to §55.0041 no later than the 10th business day after the agency received the application. H.B. 5629 also requires that a state agency that issues a license or recognizes an out-of-state license maintains a record of each complaint made against a military service member, military veteran, or military spouse to whom the agency issued a license or who holds an out-of-state license recognized by the agency. Such complaints are required to be published on a quarterly basis on the agency’s website.

Texas is a member of the enhanced Nurse Licensure Compact (eNLC), which confers privileges to practice on nurses in 43 states, which does not require the specific requirements laid out in the bill. For those that do not possess multistate licenses but qualify as military service members or military spouses, these amendments clarify the process pursuant to H.B. 5629.

The Board commends the Legislature for simplifying the process for military families that seek to practice nursing in Texas and propounds the following amendments to operationalize the requirements in H.B. 5629.

Additionally, the Board proposes amendments to 22 Texas Administrative Code §217.9 related to inactive and retired licensure status. The proposed amendments are designed to update the rules to comport with current processes and permit online status changes. These amendments will enhance efficiency for the agency and license holders.

SECTION-BY-SECTION SUMMARY OVERVIEW

22 Texas Administrative Code §217.5(h) relates to out-of-state licensure of military service members or military spouse applicants. The proposed amendment to §217.5(h) replaces the “substantially equivalent” standard for licensing requirements with the “similar in scope of practice” as required by H.B. 5629. The additional requirement that military members or their spouses who submit applications pursuant to §55.0041 be in good standing is also added to §217.5(h). The proposed amendment also adds the specified components of the licensing application as required by H.B. 5629, namely submission of the member’s military orders, a copy of the military spouse’s marriage license, and a notarized affidavit. Further, §217.5(h) is amended to reflect the Board’s obligation to notify the applicant no later than 10 business days after the date of their application submission that their out-of-state license is recognized, that their application is incomplete, or that the agency is unable to issue a license or authorization.

22 Texas Administrative Code §217.9 relates to inactive and retired licensure status. The proposed amendment provides that a nurse may change their licensure status from “active” to “inactive” status by submitting the nurse licensure deactivation form via the Texas Nurse Portal instead of through the current method of submitting a written request to the Board or making such request at the time of license renewal. Further, the proposed amendment removes the required fee associated with such request.

Texas Department of State Health Services

Proposed Rules Re:

Amending 25 TAC §1.81, to repeal the rule.

CHAPTER 1. MISCELLANEOUS PROVISIONS
SUBCHAPTER F. LICENSURE EXEMPTIONS
25 TAC §1.81

OVERVIEW

The executive commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes the repeal of §1.81, concerning Recognition of Out-of-State License of a Military Service Member and Military Spouse, and §1.91, concerning Alternative Licensing for Military Service Members, Military Spouses, and Military Veterans; and new §1.81, concerning Recognition of Out-of-State License of a Military Service Member or Military Spouse, and §1.91, concerning Alternative Licensing for Military Service Members, Military Spouses, and Military Veterans.

BACKGROUND AND JUSTIFICATION

The proposal is necessary to comply with Senate Bill (S.B.) 1818 and House Bill (H.B.) 5629, 89th Regular Session, 2025.

S.B. 1818 amends Texas Occupations Code (TOC) §55.004 and §55.0041 to allow a military service member, a military veteran, or a military spouse to receive a provisional license upon receipt of a complete application, if they meet the existing criteria outlined in TOC §55.004 or §55.0041. To qualify, the applicant must hold a current license in good standing from another state that is similar in scope of practice to a license issued in Texas.

H.B. 5629 amends Texas Occupations Code §55.004 and §55.0041 to require state agencies to recognize out-of-state licenses that are in good standing and similar in scope of practice to a Texas license, and to issue a corresponding Texas license. The bill also changes the documentation required in an application, shortens the time by which the agency must process an application, and defines “good standing.”

SECTION-BY-SECTION SUMMARY

Proposed new §1.81 allows a provisional license to be issued to any military service member or a military spouse who submits an application and meets the requirements as outlined in TOC §55.004 and §55.0041. The new rule revises language for clarity, consistency, plain language, and style. The proposed repeal of §1.81 deletes a rule that is no longer needed because it is being replaced with new §1.81.

Proposed new §1.91 allows a provisional license to be issued to any military service member, military veteran, or a military spouse who submits an application and meets the requirements as outlined in TOC §55.004 and §55.0041. The new rule revises language for clarity, consistency, plain language, and style. The proposed repeal of §1.91 deletes a rule that is no longer needed because it is being replaced with new §1.91.

Amending 25 TAC §1.81, to allow a provisional license to be issued to any military service member or a military spouse who submits an application and meets the necessary requirements.

CHAPTER 1. MISCELLANEOUS PROVISIONS
SUBCHAPTER F. LICENSURE EXEMPTIONS
25 TAC §1.81

OVERVIEW

BACKGROUND AND JUSTIFICATION

The proposal is necessary to comply with Senate Bill (S.B.) 1818 and House Bill (H.B.) 5629, 89th Regular Session, 2025.

SECTION-BY-SECTION SUMMARY

Amending 25 TAC §1.91, to repeal the rule.

CHAPTER 1. MISCELLANEOUS PROVISIONS
SUBCHAPTER G. ALTERNATIVE LICENSING FOR MILITARY
25 TAC §1.91

OVERVIEW

BACKGROUND AND JUSTIFICATION

The proposal is necessary to comply with Senate Bill (S.B.) 1818 and House Bill (H.B.) 5629, 89th Regular Session, 2025.

SECTION-BY-SECTION SUMMARY

Amending 25 TAC §1.91, to allow a provisional license to be issued to any military service member, military veteran, or a military spouse who submits an application and meets the necessary requirements

CHAPTER 1. MISCELLANEOUS PROVISIONS
SUBCHAPTER G. ALTERNATIVE LICENSING FOR MILITARY
25 TAC §1.91

OVERVIEW

BACKGROUND AND JUSTIFICATION

The proposal is necessary to comply with Senate Bill (S.B.) 1818 and House Bill (H.B.) 5629, 89th Regular Session, 2025.

SECTION-BY-SECTION SUMMARY