TITLE 26. HEALTH AND HUMAN SERVICES

PART 1. HEALTH AND HUMAN SERVICES COMMISSION

CHAPTER 307. BEHAVIORAL HEALTH PROGRAM

SUBCHAPTER H. COORDINATED SPECIALTY CARE FOR FIRST EPISODE PSYCHOSIS PROGRAM

The executive commissioner of the Texas Health and Human Services Commission (HHSC) proposes in Texas Administrative Code Title 26, Part 1, Chapter 307, new Subchapter H, comprising of §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.

BACKGROUND AND PURPOSE

The purpose of the proposal is to establish rules for the Coordinated Specialty Care for First Episode Psychosis (CSC-FEP) program. The CSC-FEP program offers outpatient mental health treatment to individuals that are at least 15 years old and up to 30 years old with a psychotic disorder.

These rules will apply to local mental health authorities (LMHAs), local behavioral health authorities (LBHAs), and community centers providing CSC-FEP program services.

SECTION-BY-SECTION SUMMARY

Proposed new §307.401 describes the purpose of the rules, which is to explain what HHSC requires to implement the CSC-FEP program.

Proposed new §307.403 provides that the rules apply to providers delivering CSC-FEP program services.

Proposed new §307.405 contains key terms and the definitions used in the proposed new rules.

Proposed new §307.407 describes eligibility requirements to enroll in the CSC-FEP program.

Proposed new §307.409 describes CSC-FEP program requirements that the providers must implement. Program requirements include the required services, implementation of services, and treatment team requirements.

Proposed new §307.411 describes standards for sufficient staffing levels and certification requirements for staff.

Proposed new §307.413 describes treatment team training requirements for staff to provide CSC-FEP program services.

Proposed new §307.415 describes the outreach and recruitment plan that a CSC-FEP program provider is required to maintain.

Proposed new §307.417 describes requirements for the CSC-FEP program provider's provision of services. Provisions include program admission requirements, service and transition planning, and ongoing safety assessment.

Proposed new §307.419 describes the requirement for a CSC-FEP program provider to submit a written waiver request for exceptions to program requirements.

FISCAL NOTE

Trey Wood, HHSC Chief Financial Officer, has determined that for each year of the first five years that the rules will be in effect, enforcing or administering the rules does not have foreseeable implications relating to costs or revenues of state or local governments.

GOVERNMENT GROWTH IMPACT STATEMENT

HHSC has determined that during the first five years that the rules will be in effect:

(1) the proposed rules will not create or eliminate a government program;

(2) implementation of the proposed rules will not affect the number of HHSC employee positions;

(3) implementation of the proposed rules will result in no assumed change in future legislative appropriations;

(4) the proposed rules will not affect fees paid to HHSC;

(5) the proposed rules will create new regulations;

(6) the proposed rules will not expand, limit, or repeal existing regulations;

(7) the proposed rules will not change the number of individuals subject to the rules; and

(8) the proposed rules will not affect the state's economy.

SMALL BUSINESS, MICRO-BUSINESS, AND RURAL COMMUNITY IMPACT ANALYSIS

Trey Wood has also determined that there will be no adverse economic effect on small businesses, micro-businesses, or rural communities because there is no requirement to alter current business practices.

LOCAL EMPLOYMENT IMPACT

The proposed rules will not affect a local economy.

COSTS TO REGULATED PERSONS

Texas Government Code §2001.0045 does not apply to these rules because the rules are necessary to protect the health, safety, and welfare of the residents of Texas and do not impose a cost on regulated persons.

PUBLIC BENEFIT AND COSTS

Trina Ita, Deputy Executive Commissioner of Behavioral Health Services, has determined that for each year of the first five years the rules are in effect, the public benefit will be the clear codification of an existing process for the implementation and provision of CSC-FEP program services in Texas. This clarity will enhance the care provided to individuals receiving CSC-FEP services.

Trey Wood has also determined that for the first five years the rules are in effect, there are no anticipated economic costs to persons who are required to comply with the proposed rules because there is no requirement to alter current business practices and there are no new fees or costs imposed on those required to comply with the proposed rules.

TAKINGS IMPACT ASSESSMENT

HHSC has determined that the proposal does not restrict or limit an owner's right to the owner's property that would otherwise exist in the absence of government action and, therefore, does not constitute a taking under Texas Government Code §2007.043.

PUBLIC COMMENT

Written comments on the proposal, including information related to the cost, benefit, or effect of the proposed rule, as well as any applicable data, research, or analysis, may be submitted to Rules Coordination Office, P.O. Box 13247, Mail Code 4102, Austin, Texas 78711-3247, or street address 4601 West Guadalupe Street, Austin, Texas 78751; or emailed to HHSRulesCoordinationOffice@hhs.texas.gov.

To be considered, comments must be submitted no later than 31 days after the date of this issue of the Texas Register. Comments must be (1) postmarked or shipped before the last day of the comment period; (2) hand-delivered before 5:00 p.m. on the last working day of the comment period; or (3) emailed before midnight on the last day of the comment period. If the last day to submit comments falls on a holiday, comments must be postmarked, shipped, or emailed before midnight on the following business day to be accepted. When emailing comments, please indicate "Comments on Proposed Rule 24R093" in the subject line.

STATUTORY AUTHORITY

The new sections are authorized by 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.

The new sections affect Texas Government Code §524.0151 and Texas Health and Safety Code §534.052.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on March 4, 2026.

TRD-202601099

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: April 19, 2026

For further information, please call: (737) 704-9063

CHAPTER 748. MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS

The executive commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §748.751, concerning What are the requirements for obtaining and verifying an applicant's employment history; §748.753, concerning What are the requirements for completing an applicant's reference checks; §748.881, concerning What curriculum components must be included in the general pre-service training; §748.887, concerning If I do not allow the use of emergency behavior intervention, what curriculum components must be included in the pre-service training for emergency behavior intervention; §748.3319, concerning What "No Trespassing" signs must I post if my operation is a residential treatment center; and the repeal of §748.3321, concerning What additional responsibilities do I have regarding the "No Trespassing" signs if my operation is a residential treatment center.

BACKGROUND AND PURPOSE

The proposal is necessary to implement House Bill (HB) 3153 and Section 6 of HB 2789, 89th Legislature, Regular Session, 2025. The proposal is also necessary to partially implement HB 16, 89th Legislature, 2nd Special Session, 2025.

HB 3153 added Texas Health and Safety Code, Chapter 811, to require general residential operations (GROs) to comply with certain employment requirements to prevent physical or sexual abuse of children.

Section 6 of HB 2789 amended Texas Human Resources Code (HRC) §42.068 to remove location and content requirements for "No Trespassing" notices required at GROs that are operating as residential treatment centers. Other rule projects are underway to implement the other sections of HB 2789.

HB 16 amended HRC §42.0426 to require a residential child-care facility to include crisis response training for emergency behavior intervention with a goal of limiting law enforcement involvement. A separate rule project will implement the bill for child-placing agencies.

The proposal updates existing requirements for obtaining and verifying an applicant's employment history; adds training for new employees regarding professional and appropriate relationships with children; includes crisis response training for emergency behavior intervention with a goal of limiting law enforcement; and removes location-specific and content requirements for "No Trespassing" notices.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §748.751 (1) amends the rule title; (2) maintains the requirement to verify an applicant's employment history, but deletes the requirement to only verify the previous five years of employment history; (3) deletes a subsection that grandfathered applicants who sought employment before August 9, 2023; and (4) makes non-substantive changes for better readability and understanding.

The proposed amendment to §748.753 (1) amends the rule title; (2) removes "within the past five years" and allows a reference check relating to a former job that involved providing care or services to children regardless of how long ago the job applicant provided the care or services; (3) deletes a subsection that grandfathered applicants who sought employment before August 9, 2023; and (4) makes non-substantive changes for better readability and understanding.

The proposed amendment to §748.881 (1) amends the rule title; (2) adds maintaining professional and appropriate conduct with children as a curriculum component for general pre-service training; and (3) makes non-substantive changes for better readability and understanding, including the renumbering of paragraphs.

The proposed amendment to §748.887 (1) amends the rule title; (2) updates a curriculum component for emergency behavior intervention training to address circumstances when all de-escalation strategies fail, including crisis response training that limits law enforcement involvement; and (3) makes non-substantive changes for better readability and understanding.

The proposed amendment to §748.3319 (1) amends the rule title; (2) removes previous location requirements for "No Trespassing" notices and replaces those requirements with a requirement that the notices be displayed in obvious locations that are clearly visible; (3) removes content requirements for the notices except for a statement that entry to the property is forbidden; (4) adds a new subsection to facilitate the proposed repeal of §748.3321; and (5) makes non-substantive changes for better readability and understanding.

The proposed repeal of §748.3321 deletes the rule as no longer necessary because (1) the "No Trespassing" notices are no longer required to identify under whose authority the notice is currently posted; and (2) the option to request new notices from Child Care Regulation has been added to proposed amended §748.3319.

FISCAL NOTE

Trey Wood, HHSC Chief Financial Officer, has determined that for each year of the first five years that the rules will be in effect, there will be an estimated additional cost to state government as a result of enforcing and administering the rules as proposed. Enforcing or administering the rules does not have foreseeable implications relating to costs or revenues of local government.

The effect on state government for each year of the first five years the proposed rules are in effect is an estimated cost of $5,170.30 in fiscal year (FY) 2027, $347 in FY 2028, $347 in FY 2029, $347 in FY 2030, and $347 in FY 2031.

GOVERNMENT GROWTH IMPACT STATEMENT

HHSC has determined that during the first five years that the rules will be in effect:

(1) the proposed rules will not create or eliminate a government program;

(2) implementation of the proposed rules will not affect the number of HHSC employee positions;

(3) implementation of the proposed rules will result in no assumed change in future legislative appropriations;

(4) the proposed rules will not affect fees paid to HHSC;

(5) the proposed rules will create a new regulation;

(6) the proposed rules will repeal existing regulations;

(7) the proposed rules will not change the number of individuals subject to the rules; and

(8) the proposed rules will not affect the state's economy.

SMALL BUSINESS, MICRO-BUSINESS, AND RURAL COMMUNITY IMPACT ANALYSIS

Trey Wood has also determined that there will be no adverse economic effect on small businesses, micro-businesses, or rural communities. The rules do not impose any additional costs on small businesses, micro-businesses, or rural communities required to comply with the rules.

LOCAL EMPLOYMENT IMPACT

The proposed rules will not affect a local economy.

COSTS TO REGULATED PERSONS

Texas Government Code §2001.0045 does not apply to these rules because the rules: (1) are necessary to protect the health, safety, and welfare of the residents of Texas; (2) do not impose a cost on regulated persons; and (3) are necessary to implement legislation that does not specifically state that §2001.0045 applies to the rules.

PUBLIC BENEFIT AND COSTS

Rachel Ashworth-Mazerolle, Associate Commissioner for Child Care Regulation, has determined that for each year of the first five years the rules are in effect the public benefit will be increased protections for children residing in GROs.

Trey Wood has also determined that for the first five years the rules are in effect, there are no anticipated economic costs to persons who are required to comply with the proposed rules because the rules do not require a GRO to (1) purchase new notices or (2) significantly update training in a manner that would result in a cost or require any additional resources to comply.

TAKINGS IMPACT ASSESSMENT

HHSC has determined that the proposal does not restrict or limit an owner's right to the owner's property that would otherwise exist in the absence of government action and, therefore, does not constitute a taking under Texas Government Code §2007.043.

PUBLIC COMMENT

Written comments on the proposal, including information related to the cost, benefit, or effect of the proposed rule, as well as any applicable data, research, or analysis, may be submitted to Rules Coordination Office, P.O. Box 13247, Mail Code 4102, Austin, Texas 78711-3247, or street address 4601 West Guadalupe Street, Austin, Texas 78751; or emailed to HHSRulesCoordinationOffice@hhs.texas.gov.

To be considered, comments must be submitted no later than 31 days after the date of this issue of the Texas Register. Comments must be (1) postmarked or shipped before the last day of the comment period; (2) hand-delivered before 5:00 p.m. on the last working day of the comment period; or (3) emailed before midnight on the last day of the comment period. If the last day to submit comments falls on a holiday, comments must be postmarked, shipped, or emailed before midnight on the following business day to be accepted. When emailing comments, please indicate "Comments on Proposed Rule 26R003" in the subject line.

SUBCHAPTER E. PERSONNEL

SUBCHAPTER F. TRAINING AND PROFESSIONAL DEVELOPMENT

SUBCHAPTER P. PHYSICAL SITE