TITLE 26. HEALTH AND HUMAN SERVICES
PART 1. HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 307. BEHAVIORAL HEALTH PROGRAM
SUBCHAPTER
H.
The executive commissioner of the Texas Health and Human Services Commission (HHSC), in Texas Administrative Code Title 26, Part 1, Chapter 307 adopts new Subchapter H consisting of new §307.401, concerning Purpose; §307.403, concerning Application; §307.405, concerning Definitions; §307.407, concerning Eligibility Requirements; §307.409, concerning Program Requirements; §307.411, concerning Staffing Requirements; §307.413, concerning Training Requirements; §307.415, concerning Outreach Plan; §307.417, concerning Service Provision; and §307.419, concerning Waiver Request.
Section 307.409 is adopted with changes to the proposed text as published in the March 20, 2026, issue of the Texas Register (51 TexReg 1794). This rule will be republished.
Sections 307.401, 307.403, 307.405, 307.407, 307.411, 307.413, 307.415, 307.417, and 307.419 are adopted without changes to the proposed text as published in the March 20, 2026, issue of the Texas Register (51 TexReg 1794). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
The new sections are necessary to establish requirements for providers delivering Coordinated Specialty Care for First Episode Psychosis (CSC-FEP) program services. These new rules outline provider qualifications, staffing requirements, training requirements, program structure, and service delivery expectations to ensure individuals experiencing a first episode of psychosis receive comprehensive, evidence-based treatment and support.
The new rules define key terms, establish eligibility criteria, and describe required services, including psychotherapy, family education and support, peer support, medication management, and support for employment and education. The new rules also set requirements for treatment team composition, service planning, documentation, safety planning, and coordination of care.
The new rules further establish expectations for provider oversight, including training requirements, outreach planning, and processes for waiver requests. These provisions promote consistency, accountability, and quality in the delivery of CSC-FEP services across contracted providers.
COMMENTS
The 31-day comment period ended April 20, 2026.
HHSC received comments regarding the proposed rules from the Meadows Mental Health Policy Institute (Meadows Institute). A summary of comments relating to the rules and HHSC's responses follows.
Comment: The commenter recommended clarifying §307.409(a)(4) regarding the requirement related to medication by adding the words "when clinically appropriate," since not all participants in a CSC-FEP program will need medication. The commenter also suggested as a part of the required services, it may be appropriate to add a new requirement in §307.409(a) for "medication evaluation and management."
Response: HHSC agrees with the commenter and added "when clinically indicated" in §307.409(a)(4). This revision ensures the rule reflects appropriate clinical discretion. HHSC declined to add for "medication evaluation and management." HHSC determined that medication evaluation and management activities are encompassed within existing clinical service expectations as indicated in §307.409(a)(4), and do not require a separate rule.
STATUTORY AUTHORITY
The new sections are adopted under Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services system, and Texas Health and Safety Code §534.052, which requires the executive commissioner to adopt rules necessary and appropriate to ensure the adequate provision of community-based mental health services through a local mental health authority.
§307.409.
(a) The provider must implement a CSC-FEP program that includes the following services:
(1) psychotherapy;
(2) family education and support;
(3) peer support for recovery from mental illness;
(4) medication prescribed to treat mental illness, when clinically appropriate; and
(5) support for education and job-related goals.
(b) The provider must:
(1) ensure the service period of up to 36 months starts on the date the provider enrolls the individual in the CSC-FEP program;
(2) establish and maintain an individual's medical record according to:
(A) state and federal laws and regulations; and
(B) the provider's admission standards and procedures;
(3) complete the uniform assessment at the individual's intake within 10 calendar days of the referral date; and
(4) conduct, review, and revise the uniform assessment according to §301.353 of this title (relating to Provider Responsibilities for Treatment Planning and Service Authorization).
(c) The provider must ensure each treatment team:
(1) maintains a census of at least 20 individuals;
(2) makes and documents five attempts to meet in person each month for the first 12 months the individual is enrolled in the CSC-FEP program. The team must document the reason why any in-person meetings did not happen; and
(3) meets at least one time a week and includes the following staff members:
(A) a team lead;
(B) a case manager or skills trainer;
(C) a certified peer specialist;
(D) a CFP; and
(E) a SEES.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on June 29, 2026.
TRD-202602664
Karen Ray
Chief Counsel
Health and Human Services Commission
Effective date: July 19, 2026
Proposal publication date: March 20, 2026
For further information, please call: (737) 704-9063
CHAPTER 561. EMPLOYEE MISCONDUCT REGISTRY
26 TAC §§561.1 - 561.9The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §561.1, concerning Purpose; §561.2, concerning Definitions; §561.3, concerning Employment and Registry Information; §561.4, concerning Investigations; §561.5, concerning Results of Investigation and Notice to Employee; §561.6, concerning Informal Review; §561.7, concerning Reportable Conduct Finding and Notice and Opportunity for Administrative Hearing; §561.8, concerning Entering Information in the EMR; and §561.9, concerning Removal from Employee Misconduct Registry.
Sections 561.1 and 561.3 - 561.9 are adopted without changes to the proposed text as published in the March 27, 2026, issue of the Texas Register (51 TexReg 1998). These rules will not be republished.
Section 561.2 is adopted with changes to the proposed text as published in the March 27, 2026, issue of the Texas Register (51 TexReg 1998). This rule will be republished.
BACKGROUND AND JUSTIFICATION
The adoption is necessary to implement Senate Bill (SB) 1849, 88th Legislature, Regular Session, 2023 and House Bill (HB) 3560, 89th Legislature, Regular Session, 2025.
SB 1849 amended Texas Health and Safety Code §253.010, which allows HHSC to amend rules related to the Employee Misconduct Registry (EMR) to establish criteria for a person to submit a request to be removed from the EMR and establish a process to determine whether a person meets the requirements for inclusion in the EMR.
SB 1849 also created new Texas Health and Safety Code (HSC) Chapter 810, Interagency Reportable Conduct Search Engine, known as Search Engine for Multi-Agency Reportable Conduct (SEMARC), which requires HHSC to amend rules to incorporate information and requirements established by new Chapter 810 relating to:
(1) definitions;
(2) designation of employees and contractors who are eligible to access the search engine;
(3) designation of additional users who are eligible to access the search engine, which may include controlling persons, hiring managers, or administrators;
(4) clarifying that an individual in the search engine is not entitled to notice or a hearing before the information is shared with another state agency or a designated user;
(5) conducting initial and periodic searches to determine whether an individual who may have access to a client has engaged in reportable conduct, and, if so, whether the individual is ineligible for employment, a volunteer position, a contract, or a license;
(6) providing notice and a due process hearing to an individual if HHSC denies, revokes, or suspends a contract or license based on that individual's reportable conduct under agency rules according to §810.006; and
(7) requiring that information contained in the search engine results and information shared with other agencies is confidential.
HB 3560 amended the definition of "facility" regarding the Employee Misconduct Registry in HSC §253.001(4) to include facilities licensed under HSC Chapter 577, Private Mental Hospitals and Other Mental Health Facilities. This adoption updates the definition of "facility" in the rules.
The adoption improves access to the rules related to the Employment Misconduct Registry by consolidating them into one chapter in the Texas Administrative Code.
The adoption is also necessary to update rules and to improve the readability and understanding of the rules.
COMMENTS
The 31-day comment period ended April 27, 2026.
HHSC did not receive any comments regarding the proposed rules.
HHSC made a minor editorial change in §561.2 to remove a comma.
STATUTORY AUTHORITY
The amendments are adopted under Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services system; Texas Health and Safety Code Chapters 253 and 810; and Texas Human Resources Code, Chapter 48, Subchapter I.
§561.2.
The following terms in this chapter have the following meanings unless the context clearly indicates otherwise.
(1) Abuse--Is defined by the law or rule that applies to investigating claims of abuse of an individual who uses the Consumer Directed Services (CDS) option or receives services from a facility or agency.
(2) Administrative hearing--A hearing held under this rule chapter by the Texas State Office of Administrative Hearings (SOAH) following a written request for a hearing by an employee challenging the HHSC reportable conduct decision for the employee.
(3) Administrative law judge--A judge from SOAH who handles administrative hearings under this chapter and according to Texas Government Code Chapter 2001.
(4) Agency--In this chapter means:
(A) a home and community support services agency licensed under Texas Health and Safety Code (HSC) Chapter 142. It provides services to children, older adults, adults with disabilities, and people receiving care in a hospice facility;
(B) a person exempt from licensing under HSC §142.003(a)(19) - (20);
(C) a state supported living center as defined in HSC §531.002;
(D) a local mental health authority as defined in HSC §531.002;
(E) a community center as defined in HSC §531.002;
(F) a contractor of an entity described in subparagraphs (C) - (E) of this paragraph;
(G) a person who contracts with a health and human services agency or Medicaid managed care organization to provide home and community-based services (HCBS) as that term is defined in Texas Human Resources Code (HRC) §48.251;
(H) a person who enters into a contract with a Medicaid managed care organization to provide behavioral health services;
(I) a Medicaid managed care organization;
(J) an officer, employee, agent, contractor, or subcontractor of a person or entity listed in subparagraphs (C) - (I) of this paragraph;
(K) an employee, fiscal agent, case manager, or service coordinator of an individual employer participating in the consumer-directed service option, as defined in Texas Government Code §546.0101; or
(L) any other program, project, waiver demonstration, or service providing long-term services and supports through the Medicaid program.
(5) Child--A person under 18 years old who is not and has not been married or who has not had the disabilities of minority removed for general purposes.
(6) Consumer directed services (CDS) option--A service delivery option, described in Chapter 264 of this title (relating to Consumer Directed Services Option) and Texas Government Code §546.0101 in which an individual or legally authorized representative (LAR) employs and retains service providers and directs the delivery of program services.
(7) Emergency--Cases of abuse, neglect, or financial exploitation that rise to the level of reportable conduct, which, without immediate intervention, would result in a child or an adult with a disability or aged 65 years old or older being in a state of harm or at risk of harm.
(8) Employee--A person who:
(A) works for a facility, agency, or individual employer;
(B) provides personal care services, active treatment, or any other personal services to an individual using the CDS option or receiving facility or agency services, or an individual who is a child for whom an investigation is authorized under Texas Family Code §261.404;
(C) provides personal care services, active treatment or any other personal services to an individual who is a child for whom an investigation is authorized under Texas Family Code §261.404;
(D) is not licensed to perform those services or is a nurse aide; and
(E) was an employee as defined in subparagraphs (A) - (D) of this paragraph and is currently on the Employee Misconduct Registry.
(9) EMR--The Employee Misconduct Registry. The registry established in HSC Chapter 253, and available on the HHSC website.
(10) Executive Commissioner--The executive commissioner of HHSC or the executive commissioner's designee.
(11) Exploitation--Is defined by the statute or rule that governs the investigation of alleged exploitation of an individual using the CDS option or receiving facility or agency services. Exploitation includes misappropriation in a nursing facility setting, as defined in 26 TAC §554.101 (relating to Definitions).
(12) Facility--In this chapter means:
(A) a nursing facility licensed under HSC Chapter 242;
(B) an assisted living facility licensed under HSC Chapter 247;
(C) a home and community support services agency licensed under HSC Chapter 142;
(D) a day activity and health services facility licensed under HRC Chapter 103;
(E) an adult foster care provider that contracts with HHSC;
(F) a prescribed pediatric extended care center licensed under HSC Chapter 248A;
(G) an intermediate care facility for individuals with an intellectual disability unlicensed or licensed by HHSC under HSC Chapter 252, including the intermediate care facility for individuals with an intellectual disability component of the Rio Grande State Center;
(H) a state supported living center licensed under HSC Chapter 555;
(I) a residential child-care facility as defined by HRC §42.002, at which an elderly person or an adult with a disability lives or is in the facility's care;
(J) a state hospital licensed under HSC Chapter 552; or
(K) a private mental hospital or other mental health facility licensed under HSC Chapter 577.
(13) Financial management services agency (FMSA)--As defined in 26 TAC §264.103 (relating to Definitions).
(14) Harm--An outcome or potential outcome of such a nature that a reasonable person would consider could have an imminent significant negative impact on the physical, mental, or emotional health of an individual.
(15) HCSSA--Home and Community Support Services Agency.
(16) HHSC--The Texas Health and Human Services Commission.
(17) HRC--Texas Human Resources Code.
(18) HSC--Texas Health and Safety Code.
(19) Individual--A person receiving services from an agency or facility.
(20) Individual employer--An individual or legally authorized representative (LAR) who participates in the CDS option. The individual employer is responsible for hiring and retaining service providers to deliver program services.
(21) Informal review (IR)--A chance for an employee to offer more information to HHSC to dispute investigation findings.
(22) SEMARC--Search Engine for Multi-Agency Reportable Conduct. As established by Texas Health and Safety Code Chapter 810.
(23) Neglect--Is defined by the statute or rule that covers how alleged neglect of an individual using the CDS option or receiving facility or agency services is investigated.
(24) Nurse Aide Registry (NAR)--The registry established in HSC §250.001(1), and available on the HHSC website.
(25) Release--The release of data outside of HHSC without the employee's consent, except for data released as allowed by law or according to this chapter.
(26) Reportable conduct--Reportable conduct, as defined in HSC §253.001 and HRC §48.401(5), which includes:
(A) abuse or neglect that causes or may cause death or harm to an individual using the CDS option or receiving facility or agency services;
(B) sexual abuse of an individual using the CDS option or receiving facility or agency services;
(C) financial exploitation of an individual using the CDS option or receiving facility or agency services in the amount of $25 or more; and
(D) emotional, verbal, or psychological abuse that causes harm to an individual using the CDS option or receiving facility or agency services.
(27) Texas State Office of Administrative Hearings (SOAH)--The state agency responsible for conducting certain administrative hearings for other state agencies, including HHSC.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on June 23, 2026.
TRD-202602575
Karen Ray
Chief Counsel
Health and Human Services Commission
Effective date: July 23, 2026
Proposal publication date: March 27, 2026
For further information, please call: (512) 348-7677
CHAPTER 711. INVESTIGATIONS OF INDIVIDUALS RECEIVING SERVICES FROM CERTAIN PROVIDERS
SUBCHAPTER
L.
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts the repeal of §§711.1401 - 711.1404, 711.1406 - 711.1408, 711.1413 - 711.1415, 711.1417, 711.1419, 711.1421, 711.1423, 711.1425 - 711.1427, 711.1429, 711.1431, 711.1432, and 711.1434, concerning Employee Misconduct Registry.
Sections 711.1401 - 711.1404, 711.1406 - 711.1408, 711.1413 - 711.1415, 711.1417, 711.1419, 711.1421, 711.1423, 711.1425 - 711.1427, 711.1429, 711.1431, 711.1432, and 711.1434 are adopted without changes to the proposed text as published in the March 27, 2026, issue of the Texas Register (51 TexReg 2005). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
The purpose of the adoption is to remove duplicate rules from the Texas Administrative Code and consolidate the rules into one chapter relating to the Employee Misconduct Registry in 26 TAC Chapter 561. The relevant information in these rules is incorporated into the rules in Chapter 561 with updates for clarification and to align the rules with statute.
COMMENTS
The 31-day comment period ended April 27, 2026.
HHSC did not receive any comments regarding the proposed rules.
STATUTORY AUTHORITY
The repealed rules are adopted under Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services system; Texas Health and Safety Code Chapters 253 and 810; and Texas Human Resources Code, Chapter 48, Subchapter I.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on June 23, 2026.
TRD-202602576
Karen Ray
Chief Counsel
Health and Human Services Commission
Effective date: July 23, 2026
Proposal publication date: March 27, 2026
For further information, please call: (512) 348-7677