TITLE 25. HEALTH SERVICES
PART 1. DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 40. STOCK MEDICATION IN SCHOOLS AND OTHER ENTITIES
The executive commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), adopts amendments to §§40.1 - 40.8, 40.11 - 40.18, 40.61 - 40.71, and 40.81 - 40.89; and the repeal of §§40.21 - 40.28, concerning Stock Medication in Schools and Other Entities.
Sections 40.1 - 40.8, 40.11 - 40.18, 40.21 - 40.28, 40.61 - 40.71, and 40.81 - 40.89 are adopted without changes to the proposed text as published in the July 3, 2026, issue of the Texas Register (51 TexReg 4339). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
The amendments and repeal are necessary to implement House Bill (HB) 163 and Senate Bill (SB) 1619, 89th Legislature, Regular Session, 2025. HB 163 amended Texas Health and Safety Code (HSC) §773.0145 by removing the statutory list of specific entities authorized to adopt a policy regarding the maintenance, administration, and disposal of epinephrine delivery systems and instead authorizing any entity in Texas to adopt such a policy. SB 1619 amended Texas Education Code Chapter 38 by replacing the term "epinephrine auto-injector" with "epinephrine delivery system" throughout relevant statutes.
The statutory changes require DSHS to update the rules to expand the entities allowed to implement an unassigned epinephrine delivery system policy and to update the medication and terminology allowed in the unassigned epinephrine delivery system policy. The amendments to 25 TAC Chapter 40, Subchapters A, B, E, and F also align definitions across Chapter 40 and comply with DSHS rule standards for plain language. The repeal of Subchapter C removes duplicative rules because the content in those rules has been incorporated into the amendments in Subchapter B.
COMMENTS
The 31-day comment period ended August 3, 2026.
DSHS received comments regarding the proposed rules from one individual commenter. A summary of comments relating to the rules and DSHS's responses follows.
Comment: A commenter expressed support for the overall rule language, including clarifying which individuals may support implementation of the rules and expanding the use of "personnel" to include volunteers and other non-paid or non-staff roles.
Response: DSHS acknowledges the comment. No amendments are necessary based on this comment.
Comment: A commenter recommended defining and including stipulations for "afterschool program" or "Out-of-School Time," noting that these programs may operate in community centers not under the management and control of an educational institution and may no longer be clearly captured after removal of "off-campus" and "secondary sites" language.
Response: DSHS disagrees with the comment. HB 163 amends HSC §773.0145 to remove the list of specific entities and authorizes any entity in Texas to adopt a policy regarding the maintenance, administration, and disposal of epinephrine delivery systems. The rules are intended to implement the statutory framework enacted by HB 163 and generally apply to entities that adopt such policies. The statute and rules do not require separate definitions or requirements for "afterschool" or "Out-of-School Time" programs. Programs that meet the applicability provisions of the statute and rules are covered regardless of whether they operate on or off a school campus. Adding a definition for only one subset of entities could unintentionally narrow or complicate implementation of a statute that was amended specifically to move away from enumerated categories of entities. Therefore, DSHS declines to amend the rules in response to this comment.
Comment: A commenter encouraged further examination of the voluntary stocking language for youth facilities and recommended requiring youth programs to stock epinephrine delivery systems, with funding support, particularly for programs serving low-income populations with barriers to allergy diagnosis, medical care, and medication access.
Response: DSHS disagrees with the comment. HB 163 authorizes entities to adopt policies regarding the maintenance, administration, and disposal of epinephrine delivery systems but does not require youth facilities or other entities to stock epinephrine delivery systems. The statute does not provide authority for DSHS to require youth programs to obtain or maintain epinephrine delivery systems or to establish a funding mechanism for such purchases. DSHS declines to make changes to the rules in response to this comment.
SUBCHAPTER
A.
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, and Texas Health and Safety Code §1001.075, which authorizes the executive commissioner of HHSC to adopt rules for the administration of Texas Health and Safety Code Chapter 1001; Texas Education Code Chapter 38 and Chapter 51, Subchapter Y-1; and Texas Health and Safety Code Chapter 773, Subchapter A.
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 September 17, 2026.
TRD-202604020
Cynthia Hernandez
General Counsel
Department of State Health Services
Effective date: October 7, 2026
Proposal publication date: July 3, 2026
For further information, please call: (512) 915-8078
SUBCHAPTER
B.
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, and Texas Health and Safety Code §1001.075, which authorizes the executive commissioner of HHSC to adopt rules for the administration of Texas Health and Safety Code Chapter 1001; Texas Education Code Chapter 38 and Chapter 51, Subchapter Y-1; and Texas Health and Safety Code Chapter 773, Subchapter A.
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 September 17, 2026.
TRD-202604021
Cynthia Hernandez
General Counsel
Department of State Health Services
Effective date: October 7, 2026
Proposal publication date: July 3, 2026
For further information, please call: (512) 915-8078
SUBCHAPTER
C.
STATUTORY AUTHORITY
The repeals 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 §1001.075, which authorizes the executive commissioner of HHSC to adopt rules for the administration of Texas Health and Safety Code Chapter 1001; Texas Education Code Chapter 38 and Chapter 51, Subchapter Y-1; and Texas Health and Safety Code Chapter 773, Subchapter A.
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 September 17, 2026.
TRD-202604022
Cynthia Hernandez
General Counsel
Department of State Health Services
Effective date: October 7, 2026
Proposal publication date: July 3, 2026
For further information, please call: (512) 915-8078
SUBCHAPTER
E.
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, and Texas Health and Safety Code §1001.075, which authorizes the executive commissioner of HHSC to adopt rules for the administration of Texas Health and Safety Code Chapter 1001; Texas Education Code Chapter 38 and Chapter 51, Subchapter Y-1; and Texas Health and Safety Code Chapter 773, Subchapter A.
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 September 17, 2026.
TRD-202604023
Cynthia Hernandez
General Counsel
Department of State Health Services
Effective date: October 7, 2026
Proposal publication date: July 3, 2026
For further information, please call: (512) 915-8078
SUBCHAPTER
F.
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, and Texas Health and Safety Code §1001.075, which authorizes the executive commissioner of HHSC to adopt rules for the administration of Texas Health and Safety Code Chapter 1001; Texas Education Code Chapter 38 and Chapter 51, Subchapter Y-1; and Texas Health and Safety Code Chapter 773, Subchapter A.
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 September 17, 2026.
TRD-202604024
Cynthia Hernandez
General Counsel
Department of State Health Services
Effective date: October 7, 2026
Proposal publication date: July 3, 2026
For further information, please call: (512) 915-8078