TITLE 26. HEALTH AND HUMAN SERVICES
PART 1. HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 358. CHILDREN'S AUTISM PROGRAM
The executive commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §§358.101, 358.105, 358.307, 358.311, 358.313, 358.315, 358.605, 358.607 - 358.609; the repeal of §§358.309, 358.507, and 358.515; and new §§358.107, 358.109, 358.201, and 358.309.
BACKGROUND AND PURPOSE
The purpose of the proposal is to update the Children's Autism Program rules in Title 26 Texas Administrative Code (TAC) Chapter 358, including definitions and contractor qualifications. The proposal would also replace references to the former Texas Department of Assistive and Rehabilitative Services with HHSC.
The proposal changes the program eligibility requirement based on age. This change aligns with the other program within the Children's Autism and Blindness Services section, the Blind Children's Program.
Additionally, the Children's Autism Program rules are in two different TAC chapters. HHSC is proposing to repeal the rules in 1 TAC Chapter 392, Subchapter C, Autism Program, to consolidate the program rules into one chapter in 26 TAC Chapter 358. The proposed repeal of the 1 TAC Chapter 392 rules are published elsewhere in this issue of the Texas Register.
SECTION-BY-SECTION SUMMARY
Subchapter A General Rules
The proposed amendment to §358.101, Purpose, changes the title of the rule to "Purpose and Program Administration" and formats the rule into new subsections (a) - (c). New subsection (a) states the chapter implements the HHSC Children's Autism Program to provide services to children and young adults diagnosed with an autism spectrum disorder who are younger than 22 years of age; new subsection (b) states local community agencies and organizations provide Focused Applied Behavior Analysis or other treatments through grant contracts with HHSC; and new subsection (c) states HHSC may operate the program only if the Texas Legislature appropriates funding for the program.
The proposed amendment to §358.105, Definitions, revises the definitions of "adjusted gross income," "allowable deductions," "child or children," "contractor," "cost share," "dependent," "direct services," "family," "interest list," "parent," "Texas resident," "third party payer," and "treatment plan" for clarity. The proposed amendment revises the definition of "applied behavior analysis" to add the acronym "ABA" so that the acronym can be used in the rules. The proposed amendment revises the definition of autism spectrum disorders to add the acronym "ASD" so that the acronym can be used in the rules; and to add a reference to the eligibility criteria for a documented diagnosis in proposed amended §358.307(a). The proposed amendment revises the definitions for "BCaBA," "BCBA" and "BCBA-D," to add the formal title for each acronym and a reference to the requirements in the Texas Occupations Code for each person who uses these titles. The proposed amendment revises the definition for "parent training" to clarify the meaning and remove requirements that have been added in proposed §358.11. The proposed amendment revises the definition for "qualified professional" to clarify who is trained to provide a neurodevelopmental disorder diagnosis. The proposed amendment revises the definition for "transition plan" to clarify the meaning of this term.
The proposed amendment also removes the definitions for "HHSC Comprehensive ABA services" and "HHSC Focused ABA services" and replaces them with a new definition for "Focused ABA services" to clarify the type of services provided by Children's Autism Program contractors. The proposed amendment adds definitions for "physician" and "psychologist" to include their licensure requirements and because these terms are used in the proposed amended definition of "qualified professional" in renumbered §358.105(25).
The proposed amendment also adds a definition of "RBT--Registered Behavior Technician" because this term, which includes a Board Certified Autism Technician, are the titles used by a paraprofessional who provides direct support, under the supervision of a BCBA or BCaBA, to individuals enrolled in the Children's Autism Program. The proposed amendment adds a definition of "staff member" to clarify what this term means when used in the chapter. The proposed amendment renumbers the paragraphs in this rule accordingly.
Proposed new §358.107, Criminal Background Checks, describes the requirements for a contractor to conduct criminal background checks on an employee, staff member, volunteer, or other person who will have direct contact with children and families who receive services. The proposed new rule replaces the requirements in 1 TAC §392.205 Criminal Background Checks, which HHSC is proposing to repeal.
Proposed new §358.109, Safety, requires a contractor to maintain an emergency evacuation plan and describes requirements for the plan. The proposed new rule requires a contractor to notify a family if any emergency happens with a child. The proposed new rule replaces the requirements in 1 TAC §392.207 Safety, which HHSC is proposing to repeal.
New Subchapter B Staff Requirements
Proposed new §358.201, Staff Requirements, provides qualifications for the BCBA or BCBA-D, who acts as program manager. The proposed new rule provides some additional requirements for staff who are providing direct services. The proposed new rule replaces the requirements in 1 TAC §392.203 Staff Qualifications, which HHSC is proposing to repeal.
Subchapter C Focused ABA Services
The proposed amendment changes the title of Subchapter C from "DARS" to "Focused ABA Services" because the Department of Aging and Rehabilitative Services no longer exists and because the subchapter addresses services provided by the Children's Autism Program.
The proposed amendment to §358.307, Eligibility, changes eligibility based on age from three through 15 years old to younger than 22 years old. This change fills a significant gap in the availability of autism services for children and young adults.
The proposed repeal of §358.309, Enrollment, removes the rule to include its contents in proposed new §358.309, Enrollment and Interest List. This change is made for organizational purposes.
Proposed new §358.309, Enrollment and Interest List, contains the requirements for a contractor to enroll an eligible child and to maintain an interest list. The proposed new rule provides the basis for a child who leaves the program with unused service hours to receive priority over children on the interest list who have never received services.
The proposed amendment to §358.311, Services Provided, updates and clarifies the requirements for a contractor to develop a written treatment plan in new subsection (a). The proposed amendment organizes the requirements for a contractor to provide and document parent training in new subsections (b) - (d). The proposed amendment organizes the requirements for a contractor to evaluate progress; collect data; document coordination of services; develop and maintain a transition plan; and document all services provided to the child in new subsection (e). These changes make the rules easier to locate and follow. The proposed amendment renumbers the rules because of the changes in its organization.
The proposed amendment to §358.313, Amount of Services, replaces "length" with "amount" in the title and rule to clarify it is the amount of Focused ABA services, not the length of services that a contractor may provide to a child, that determines when the child reaches the limit of 720 total hours of services. The proposed amendment adjusts the requirements for usage of service hours. The proposed amendment updates when a child reaches a service limit by removing "has received 180 hours of services in a year" and updating the age of eligibility to 22 years of age. The proposed amendment removes subsection (f) because the content of the rule has been added to the proposed amendment to §358.309. The proposed amendment renumbers subsection (g) as subsection (f). The proposed amendment to renumbered subsection (f) makes changes to make it easier to read and understand.
The proposed amendment to §358.315, Participation Requirements, in subsection (a) clarifies the attendance requirement for a child during the year, the benefits of attendance, and states absences for any reason do not change the attendance requirement. The proposed amendment in subsection (b) expands the requirement for a parent to attend parent training sessions from a minimum of once every two weeks to at least two times each month. This change provides the opportunity to arrange the parent training schedule to meet the needs of the child and the child's services. The proposed amendment removes subsection (c) because it is no longer required for a parent and the child to participate in pre-test and post-test protocols. The proposed amendment renumbers subsection (d) as subsection (c) and makes it easier to read and understand that a child may be removed from the program if the parent or child does not met the participation requirements and that a contractor may allow an exception to these requirements if HHSC provides written approval.
Subchapter E Autism Program Rights
The proposed repeal of §358.507, Rights of Children and Parents, removes content that is unnecessary because discrimination and retaliation are prohibited across HHS agencies.
The proposed repeal of §358.515, Staff Requirements, is needed because the content of the rule is in proposed new §358.201, Staff Requirements.
Subchapter F Cost Share
The proposed amendment to §358.605, Cost Share, makes minor rule edits and updates a rule reference.
The proposed amendment to §358.607, HHSC Fee Schedule Amount, clarifies the requirement for the contractor to calculate the monthly fee that a family must pay for services of each eligible child. The proposed amendment changes "services" to "Focused ABA services" to be more specific. The proposed amendment removes obsolete references to §105.105.
The proposed amendment to §358.608, Insurance Payments, clarifies the requirement for a contractor to accept insurance payment as full payment. The proposed amendment also clarifies that the family's cost share must be the lower amount between the HHSC fee schedule amount or the insurance deductible, copayment, or coinsurance.
The proposed amendment to §358.609, Payer of Last Resort, makes minor rule language edits to clarify the program standards for not using HHSC funds to provide payment for services until all other payment options have been used first.
FISCAL NOTE
Trey Wood, 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 expand and 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 the rules will not cause an increased cost of services to any contractor.
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 do not impose a cost on regulated persons.
PUBLIC BENEFIT AND COSTS
Haley Turner, Deputy Executive Commissioner for Community Services, has determined that for each year of the first five years the rules are in effect, the public benefit will be increased clarity on terms and Children's Autism Program services. Another anticipated public benefit is increased access to services by expanding the age of eligibility.
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.
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 25R044" in the subject line.
SUBCHAPTER
A.
STATUTORY AUTHORITY
The amendments and 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 Human Resources Code §117.082, which requires HHSC to adopt rules for the children's autism program.
The amendments and new sections implement Texas Government Code §524.0151 and Texas Human Resources Code §117.082.
§358.101.
(a)
This chapter implements [The purpose of] the Texas Health and Human Services Commission (HHSC) [Commission (HHSC)] Children's Autism Program. This program provides [is to provide] autism services to children and young adults diagnosed [3 through 15 years of age] with an autism spectrum disorder (ASD) who are younger than 22 years of age.
(b)
Local [Services are provided through grant contracts with local] community agencies and organizations, through grant contracts with HHSC, provide services using Focused [utilizing] Applied Behavior Analysis (ABA) or other treatments [treatment approaches].
(c)
HHSC may operate [is authorized to implement] the program only if [to the extent that funds are appropriated by] the Texas Legislature funds the program.
§358.105.
The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise.
(1)
Adjusted gross income--The total [gross] income of the family after subtracting[, as defined in this section, minus] allowable deductions. Adjusted gross income is used to calculate a family's monthly cost share for a child to participate in the Children's Autism Program [determine the amount of the monthly financial contribution required by a family].
(2)
Allowable deductions--Expenses that may be subtracted from total income [are not reimbursed by other sources]. Allowable deductions are limited to:
(A)
the actual medical or dental expenses of the family [parent or dependent] that are mainly for helping [primarily related to alleviating] or preventing a physical or mental condition [defect or illness], paid within the last [were paid over the previous] 12 months, and [are] expected to continue during the eligibility period. Expenses must be[, and are] limited to the cost of:
(i) diagnosis, cure, alleviation, treatment, or prevention of disease;
(ii) treatment of any affected body part or function;
(iii) legal medical services delivered by physicians, surgeons, dentists, and other medical practitioners;
(iv) medication, medical supplies, and diagnostic devices;
(v) premiums paid for insurance that covers the expenses of medical or dental care;
(vi) transportation to receive medical or dental care; and
(vii) medical or dental debt that is being paid on an established payment plan;
(B) child-care and respite expenses for a family member;
(C)
costs and fees associated with the adoption of a [dependent] child who will be counted as a family member; and
(D)
court-ordered child support payments paid for a child who is not counted as a family member [or dependent].
(3)
ABA--Applied behavior analysis. [(ABA)--] The design, implementation, and evaluation of systematic environmental changes to produce socially significant change in human behavior through skill acquisition and the reduction of problematic behavior. Applied behavior analysis includes direct observation and measurement of behavior and the identification of functional relations between behavior and the environment. Contextual factors, establishing operations, antecedent stimuli, positive reinforcers, and other consequences are used to produce the desired behavior change.
(4)
ASD--Autism spectrum disorder, a disorder [disorders--The disorders] found in the fifth [current] edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) related to autism or a[. An autism spectrum disorder (ASD)] diagnosis of autistic disorder, Asperger's disorder, or pervasive developmental disorder not otherwise specified, made under a previous DSM, used to meet the eligibility criteria for a documented diagnosis in §358.307(a) of this chapter (relating to Eligibility) [is acceptable].
(5)
BCaBA--Board Certified Assistant Behavior Analyst. A person who meets the requirements in and holds the appropriate license under Texas Occupations Code Chapter 506, the Behavior Analyst Licensing Act [A board certified assistant behavior analyst].
(6)
BCBA--Board Certified Behavior Analyst. A person who meets the requirements in and holds the appropriate license under Texas Occupations Code Chapter 506 [A board certified behavior analyst].
(7)
BCBA-D--Board Certified Behavior Analyst-Doctoral. A person who meets the requirements in and holds the appropriate license under Texas Occupations Code Chapter 506. [A board certified behavior analyst-doctoral.]
(8)
Child--An individual diagnosed with ASD who is younger than 22 years of age. [A son, daughter, foster child, or stepchild who is under age 19 living in the home.]
(9)
Contractor--A local community agency or organization [service provider] under contract with HHSC to provide [autism] services under this chapter.
(10)
Cost share--The amount of money a family must pay each month [monthly financial contribution required of a family] for a child to participate in the [HHSC] Children's Autism Program, as described in Subchapter F of this chapter (relating to Cost Share). [The cost share is determined using the HHSC Fee Schedule and any applicable insurance deductible, coinsurance, and co-pay amounts. The cost share is the lesser of the fee determined using the HHSC fee schedule, or applicable insurance deductible, coinsurance, and co-pay amounts.]
[(11) HHSC Comprehensive ABA services--ABA services that are provided to children 3 through 5 years of age by a HHSC contractor to treat all areas of developmental and behavioral needs.]
[(12) HHSC Focused ABA services--ABA services that are provided to children 3 through 15 years of age by a HHSC contractor to treat one or more deficits or behaviors of excess rather than the full range of developmental domains.]
(11) [(13)] Dependent--Aperson in the household of a child who receives services who is [age] 19 years of age or older, a parent, a guardian, a stepparent, a grandparent, a brother, a sister, a stepbrother, a stepsister, or an in-law. Dependents may not have [; whose] gross income more [is less] than the income requirement set by the Internal Revenue Service (IRS) for the relevant [$3,900 a] year. More[; and for whom more] than half of the person's support must be [is] provided [for] by the parent [parent(s) or guardian(s)] during the calendar year.
(12) [(14)] Direct services [contact]--Direct services happen when a staff member provides services to a child or the family. Direct services include parent or family training, in person and virtual ABA sessions, and meetings related to the service plan. [A term that applies to any person who has physical contact with, physical access to the home of, communication with, or access to confidential information regarding a child enrolled in the HHSC Children's Autism Program or the child's family.] Direct services do [contact does] not include casual or accidental [inadvertent] physical contact with, talking to [communication with], or meeting [contact] at an educational presentation or seminar with a child who is [enrolled] in the [HHSC] Children's Autism Program or with the child's family.
(13) [(15)] Family--If living in the same home, means:
(A)
the parent; [The child's parent(s) or guardian(s),]
(B)
the child;[,]
(C)
other children younger than [under] 19 years old; [of age] and
(D)
other dependents [of the parent or guardian].
(14) [(16)] Fiscal year--The state fiscal year. Begins on September 1 and ends on August 31 of the following year.
(15) Focused ABA services--ABA services provided to a child by an HHSC contractor to treat one or more skill deficits or behaviors.
(16) [(17)] Gross income--All income received by the family for determination of the family's cost share, from whatever source, that is considered income by the Internal Revenue Service before federal allowable deductions are applied.
(17) [(18)] HHSC--The Texas Health and Human Services Commission.
(18) [(19)] Individualized Education Program (IEP)--A written document that is developed for each public school child who is eligible for special education.
(19) [(20)] Interest list--A list, maintained by a [the] contractor, of families who have indicated an interest in receiving services, and who meet the eligibility criteria.
[(21) LEA--Local educational agency.]
(20) [(22)] Parent--Means:
(A)
a [The] child's natural or adoptive parent; or
(B)
a [the] child's guardian.
(21) [(23)] Parent training--A Focused ABA service that a contractor provides [Training that is provided] to a parent [or guardian as part of the ABA service,] in the native language of a parent with limited English proficiency, [used by the parents of the child] when possible [feasible]. [It is delivered either individually or in a group in a home, school, or clinic setting. It includes providing parent education on ABA in general; working collaboratively with parents to identify ways they can help their child at home to generalize learning to other environments, including school settings; and data review, program adjustment, and planning.]
(22) Physician--A person licensed to practice medicine under Texas Occupations Code Chapter 155.
(23) Psychologist--A person licensed to practice psychology under Texas Occupations Code Chapter 501.
(24)
Qualified professional--A [An actively licensed] physician or psychologist who has [with] training and experience in diagnosing [background related to the diagnosis] and treating [treatment of] neurodevelopmental disorders.
(25) RBT--Registered Behavior Technician. A paraprofessional who provides direct support to individuals, under the supervision of a BCBA or BCaBA. A RBT implements behavior intervention plans, collects data, and assists individuals to develop or improve skills and manage challenging behaviors. This term also includes a Board Certified Autism Technician.
(26) Staff member--Means a person working for a contractor as:
(A) an RBT;
(B) a BCaBA;
(C) a BCBA; or
(D) a BCBA-D.
(27) [(25)] Texas resident--A person who lives [resides] in Texas. [and intends to remain in the state, either permanently or for an indefinite period.]
(28) [(26)] Third-party payer--A company, organization, insurer, or government agency, except for [other than] HHSC, that pays [makes payment] for health care services a child receives in the Children's Autism Program [received by an enrolled child].
(29) [(27)] Transition plan--A written document that lists the [A plan that identifies and documents appropriate] steps and [transition] services needed to help [support] the child and family move [to smoothly and effectively transition] from the [HHSC] Children's Autism Program to local education agency [LEA] special education services or other community activities, places, or programs chosen by the family [would like the child to participate in] after leaving [exiting] the [HHSC] Children's Autism Program.
(30) [(28)] Treatment plan--A written plan of care that describes how services will be provided to a child and the child's family to enhance the child's development, that includes [, including] treatment goals.[, for providing HHSC autism treatment services to an eligible child and the child's family to enhance the child's development. The intensity and length of Children's Autism Program services is determined by the treatment goals included in the treatment plan. However, the length of autism services shall not exceed 24 months.]
§358.107.
(a) A contractor must complete a fingerprint-based review of national criminal history records on any employee, staff member, volunteer, or other person who will have direct contact with children and families served by the Children's Autism Program.
(b) Contracts between HHSC and a contractor explain which offenses will prevent an employee, staff member, volunteer, or other person from having direct contact with children and families who receive services.
(c) With written approval from HHSC, a contractor may review and assess the risk of a minor criminal history finding for any employee, staff member, volunteer, or other person who will engage in direct services.
§358.109.
(a) A contractor must:
(1) maintain an emergency evacuation plan at the contractor's service site; and
(2) review the plan at least annually, and after every use of the evacuation plan, to evaluate the effectiveness of the plan and to update the plan as needed.
(b) A contractor's emergency evacuation plan must be approved and signed annually by the program supervisor.
(c) A contractor's emergency evacuation plan must follow all local, state, and federal laws, rules, and regulations that apply to services under this chapter.
(d) A contractor must notify a family if any emergency happens with a child, including any situation that poses an immediate threat to life, health, property, or the environment and requires urgent action.
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 April 20, 2026.
TRD-202601676
Karen Ray
Chief Counsel
Health and Human Services Commission
Earliest possible date of adoption: May 31, 2026
For further information, please call: (512) 815-6272
SUBCHAPTER
B.
STATUTORY AUTHORITY
The new section is 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 Human Resources Code §117.082, which requires HHSC to adopt rules for the children's autism program.
The new section implements Texas Government Code §524.0151 and Texas Human Resources Code §117.082.
§358.201.
(a) A contractor must have a manager to supervise all staff members and oversee assessments and treatments for children. The program manager must be a BCBA or BCBA-D and have:
(1) at least one year of experience in providing services to children diagnosed with ASD who are younger than 22 years old;
(2) a master's or doctoral degree from an accredited institution of higher education in psychology, behavior analysis, or a related field;
(3) documented graduate-level coursework in:
(A) behavioral assessment and intervention;
(B) selecting outcomes and strategies;
(C) behavior change procedures;
(D) experimental methods; and
(E) measuring and interpreting behavioral data; and
(4) knowledge of typical human development for individuals from the age of 1 to 22 years old.
(b) A contractor must make sure all staff, including an RBT, involved in direct services:
(1) has earned a high school diploma or certificate that a state recognizes as equivalent to a high school diploma; and
(2) is at least 18 years old.
(c) A BCBA or BCBA-D must supervise all staff members with direct contact. Supervision must include:
(1) direct observation of autism services at least once every two calendar weeks to check if a staff member uses procedures correctly and to help the supervisor decide if teaching methods should be changed; and
(2) ongoing review of data from Focused ABA programs and client data related to problem behavior at least two times each week.
(d) Each staff member involved in direct services, except for BCBA and BCBA-D, must complete training before working independently and meet all minimum training requirements for credentials and licensing, in addition to completing training annually. Each staff member must complete at least 40 hours of training that meets the following requirements.
(1) Formal training must be developed and overseen by a BCBA or BCBA-D supervisor. Training must cover methods for collecting data, steps for carrying out discrete trial teaching, ways to use prompting procedures, behavior management strategies for addressing problem behavior, and other Focused ABA techniques and program specific methods.
(2) Training must be provided or overseen by a BCBA or BCBA-D supervisor through classroom instruction, workshops, reading assignments, observation of modeling of techniques by supervisors, role-play with supervisors, and training in the natural environment in which supervisors provide specific feedback and additional training as needed.
(3) Training effectiveness is checked through written tests administered by the contractor with clear standards for mastery, or by direct observation from a BCBA or BCBA-D supervisor using fidelity checklists to confirm correct use of procedures and mastery of required skills. Training must make sure staff gain the skills necessary to provide Focused ABA services or other treatments correctly.
(4) Training must include all the tasks in the Behavior Analyst Certification Board's Registered Behavior Technician Task List and Guidelines for Responsible Conduct for Behavior Analysts that have been designated as relevant for behavior technicians.
(5) Training must include instruction in the following areas:
(A) ethics and professional conduct;
(B) child development from birth to less than 18 years of age; and
(C) human development from 18 years of age to less than 22 years of age.
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 April 20, 2026.
TRD-202601677
Karen Ray
Chief Counsel
Health and Human Services Commission
Earliest possible date of adoption: May 31, 2026
For further information, please call: (512) 815-6272
SUBCHAPTER
C.
DARS] FOCUSED ABA SERVICES
STATUTORY AUTHORITY
The amendments and new section 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 Human Resources Code §117.082, which requires HHSC to adopt rules for the children's autism program.
The amendments and new section implement Texas Government Code §524.0151 and Texas Human Resources Code §117.082.
§358.307.
(a)
To be eligible for the Children's Autism Program [HHSC Focused ABA services], a child must:
(1)
be a Texas resident [as defined in §105.105 of this chapter (relating to Definitions)];
(2) have a documented diagnosis on the autism spectrum made by a qualified professional; and
(3)
be younger than 22 [3 through 15] years old [of age].
[(b) Children become eligible on their third birthday and become ineligible on their 16th birthday.]
[(c) The parent must participate in parent training, defined in §105.105 of this chapter in order for their child to receive services.]
(b) [(d)] An offer to enroll in the Children's Autism Program depends on whether funding is available and whether the contractor can serve more children. When a contractor considers a [Eligibility for HHSC Focused ABA services does not guarantee enrollment into the HHSC Children's Autism Program. A] child [considered] eligible for services and there is no opening or funding available to enroll the child, the contractor must add the child [by the contractor based on the criteria in this section is added] to the contractor's interest list as described in §358.309 of this subchapter (relating to Enrollment and Interest List) [when there is no opening or funding available for HHSC Focused ABA services in the local HHSC Children's Autism Program].
§358.309.
(a) A contractor must:
(1) enroll an eligible child in the Children's Autism Program, except as provided in §358.307(b) of this subchapter (relating to Eligibility);
(2) provide the family written information about the estimated highest possible monthly cost of Focused ABA services and the estimated amount of cost share the family must pay;
(3) confirm the benefits if the contractor discovers a child may have third-party payer coverage via pre-authorization for billing of services provided in the Children's Autism Program, and keep related documentation on file; and
(4) provide written notice to the child and parent that explains:
(A) the responsibilities of the child and parent that must be met to prevent the child from being dismissed from the program, as described in §358.315 of this subchapter (relating to Participation Requirements); and
(B) the rights of the child and parent under Subchapter E of this chapter (relating to Autism Program Rights).
(b) A contractor must maintain an interest list. If a contractor cannot immediately enroll an eligible child into the Children's Autism Program and the family is interested in enrolling, the contractor adds the child's information to the interest list. The interest list must include the child's name, date of birth, parent name, phone number and email address.
(c) Every six months, a contractor must check the interest list to confirm that each child still meets the eligibility criteria in §358.307(a) of this subchapter (relating to Eligibility) and that the family is still interested in enrolling the child in the Children's Autism Program.
(d) A contractor removes a child's information from the interest list when:
(1) an opening becomes available and the contractor enrolls the child in the Children's Autism Program;
(2) the child is no longer eligible for the Children's Autism Program based on the criteria in §358.307(a) of this subchapter; or
(3) the family tells the contractor that the family is no longer interested in enrolling the child in the program.
(e) A child who leaves the Children's Autism Program with unused service hours receives priority over children on the interest list who have never received services:
(1) when the child or family reapply for additional autism services;
(2) if the child continues to meet the eligibility criteria in §358.307(a) of this subchapter; and
(3) based on:
(A) the child's needs; and
(B) available funding.
§
358.311.
(a)
A [The] contractor must:
(1)
develop a written treatment plan with the family for each child served, which must include; [, including plans for generalization of learned skills and behaviors to other environments;]
(A) goals that are clear, specific, and can be measured and will direct the treatment process and show progress; and
(B) plans that help the child use skilled and behaviors learned during services in other places, such as home or school; and
[(2) provide and document parent training as a component of the services. Documentation must include:]
[(A) the date of the training;]
[(B) the names of those who participated in the training; and]
[(C) any information that was discussed and shared by the contractor;]
(2) [(3)] provide and keep records of parent training as a part of the Focused ABA services. [ongoing analysis and evaluation of each child's progress;]
(b) A contractor must provide parent training. A contractor may provide this training in either individual or group format. If provided in a group of other parents and children, a contractor may provide parent training in a home, school, or clinic setting.
(c) Parent training must include:
(1) providing education to the parent about ABA;
(2) the contractor working with the parent to find ways to help the child practice skills at home so learned skills can carry over to other places, including school settings; and
(3) teaching the parent how to review data, make decisions about the program, and plan for new goals.
[(4) document services provided to each child;]
[(5) collect data on operationally defined target behaviors. Data on at least three data points will be collected at baseline, during treatment, and post-treatment for each behavior that is identified in the child's treatment plan. No additional pre- and post-testing is required;]
[(6) document efforts to coordinate services with the school setting the child attends to promote generalization;]
[(7) create with the family and maintain documented transition plans for each child leaving services;]
[(8) maintain in the child's record the following documentation related to the transition plan:]
[(A) timelines for each transition activity;]
[(B) the family's choice for the child to transition into a community or educational program or for the child to remain in the home; and]
[(C) appropriate steps and transition services to support the family's exit from the HHSC Children's Autism Program services to LEA special education services or other appropriate activities, places, or programs the family would like the child to participate in after exiting services; and]
(d) [(9)] Documentation of [document all services provided, including] parent training must include [, including]:
(1) [(A)] the [child's] name of the child;
(2) [(B)] the names of those who participated in the training [date of service];
(3) [(C)] any training information the contractor discussed and shared with each parent who participated in the training; and [start and end time of service;]
(4) [(D)] the location where the contractor provided the training. [of service;]
[(E) names of those present for service;]
[(F) contractor's signature;]
[(G) description of the service and goals addressed; and]
[(H) progress toward goals.]
(e) A contractor must:
(1) provide ongoing analysis and evaluation of each child's progress;
(2) collect data on operationally defined target behaviors at baseline, during treatment, and after treatment for every behavior listed in the child's treatment plan;
(3) document efforts to coordinate services with the school setting the child attends to promote the child's use of learned skills in that setting so learned skills can carry over to other places;
(4) develop a written transition plan with the child and family before each child exits the Children's Autism Program;
(5) maintain an updated transition plan in the child's record and include in the transition plan:
(A) timelines for completing each of the steps and transition services documented in the plan to support the family's exit from the Children's Autism Program; and
(B) the family's choice for the child to:
(i) transition to local education agency special education services or other community activities, places, or programs the family would like the child to participate in after exiting the Children's Autism Program; or
(ii) remain in the home; and
(6) maintain documentation in the child's record of all services provided to the child that includes:
(A) the child's name;
(B) the date of service;
(C) the start and end time of service;
(D) the location of service;
(E) the names of those present during the time of service;
(F) the contractor's signature;
(G) a description of the service and goals addressed; and
(H) progress toward goals.
§358.313.
Length] of Services.
(a)
The amount [length] of Focused ABA services provided for a child is based on the child's specific needs. [but must not exceed a maximum of 24 months in the HHSC Children's Autism Program in any combination of Comprehensive or Focused ABA services.]
(b)
A [The] contractor may provide up to 720 total hours of [HHSC] Focused ABA services to a child as long as the child meets the eligibility requirements in §358.307(a) [§105.307] of this subchapter [chapter] (relating to Eligibility). [The contractor may not exceed 180 hours within a year of the first date of service.]
(c)
Any change [The time-limited services are not affected by any modifications] in [the contract between HHSC and the] contractors while a child is receiving services does not affect the number of hours of services the child accumulates. The total of 720 service hours is cumulative across various contractors and service arrangements[, or a change in the contractor].
(d)
[HHSC] Focused ABA services end when a child: [treatment]
(1)
meets the goals in the treatment plan; or [are met or when]
(2)
reaches a service limit in subsection (e) of this section [limits have been reached].
(e)
A child reaches a service limit [Service limits have been reached] when the child:
[(1) has received 180 hours of services in a year;]
(1) [(2)] receives [has received] 720 total hours of Focused ABA services before the child's 22nd [his or her 16th] birthday; or
(2) [(3)] reaches 22 years of age [his or her 16th birthday].
[(f) Children who exit HHSC Focused ABA services with remaining hours of service may reapply for additional HHSC Focused ABA services based on the eligibility criteria in §105.307 of this chapter, the child's needs, available funding, and the contractor's ability to serve more children in accordance with §105.307 of this chapter. These children are given priority over children on the interest list who have not previously received services.]
(f) [(g)] A family may [choose to] continue [receiving] services from the contractor [, at the family's expense, from the contractor] after the child reaches a service limit [limits noted] in subsection (e) [(b)] of this section if the family pays for the services [have been reached]. HHSC does not pay [is not liable] for any costs [incurred] after a service limit is [limits have been] reached, including the contractor's [any] cost for [incurred by a contractor] providing those services.
§358.315.
(a)
A [The] child must attend at least 85 percent of scheduled [HHSC] Focused ABA services during [over] the year. A child needs to attend these services to get the full [This is necessary for the child to fully] benefit from Focused ABA [the] services. Absences, for any reason, do not change the attendance requirement [, regardless of the reason for the absence].
(b)
A parent must attend [Participation in] parent training sessions scheduled by the contractor at least two times each month, [, a minimum of once every two weeks as defined in §105.105(23) of this chapter (relating to Definitions), is required] for the [a] child to continue to receive services.
[(c) The parent and the child must participate in pre-test protocols upon enrollment into HHSC Focused ABA services. The parent and the child must participate in post-test protocols before exiting HHSC Focused ABA services.]
(c) [(d)] If a [the] parent or [and the] child does not [fail to] meet the participation [these] requirements in this section, the child may be removed [dismissed] from the [HHSC] Children's Autism Program. A contractor may allow an exception to these [The] requirements if HHSC provides [may be waived with] written approval [by HHSC].
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 April 20, 2026.
TRD-202601679
Karen Ray
Chief Counsel
Health and Human Services Commission
Earliest possible date of adoption: May 31, 2026
For further information, please call: (512) 815-6272
SUBCHAPTER
C.
STATUTORY AUTHORITY
The repeal is 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 Human Resources Code §117.082, which requires HHSC to adopt rules for the children's autism program.
The repeal implements Texas Government Code §524.0151 and Texas Human Resources Code §117.082.
§358.309.
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 April 20, 2026.
TRD-202601678
Karen Ray
Chief Counsel
Health and Human Services Commission
Earliest possible date of adoption: May 31, 2026
For further information, please call: (512) 815-6272
SUBCHAPTER
E.
STATUTORY AUTHORITY
The repeals 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 Human Resources Code §117.082, which requires HHSC to adopt rules for the children's autism program.
The repeals implement Texas Government Code §524.0151 and Texas Human Resources Code §117.082.
§358.507.
§358.515.
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 April 20, 2026.
TRD-202601680
Karen Ray
Chief Counsel
Health and Human Services Commission
Earliest possible date of adoption: May 31, 2026
For further information, please call: (512) 815-6272
SUBCHAPTER
F.
STATUTORY AUTHORITY
The amendments 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 Human Resources Code §117.082, which requires HHSC to adopt rules for the children's autism program.
The amendments implement Texas Government Code §524.0151 and Texas Human Resources Code §117.082.
§358.605.
(a)
A [The] family's cost share amount must be the lower amount [is the lesser] of the:
(1)
HHSC Fee Schedule [fee schedule] amount; or
(2) applicable deductible, copayment, and coinsurance amounts when the family has insurance that covers the Focused ABA services.
(b)
If a [the] parent disagrees with the contractor's determination of the family's ability to pay the cost share, the parent may [can]:
(1)
request a review by the contractor's management [manager or program director];
(2) file an informal or formal complaint with the contractor; or
(3)
contact the HHSC [HHS] Office of the Ombudsman at 1-877-787-8999, for help resolving a problem or concern with the contractor.[; and]
[(4) file a formal complaint with HHSC as noted in §105.509 of this chapter (relating to Complaint Process).]
§358.607.
(a)
To [The contractor is required to use the HHSC Fee Schedule and instructions to] calculate the cost share that a [monthly fee owed by the] family must pay for [the] services of each eligible child, the contractor must use the HHSC Fee Schedule found in the HHSC contractor database according to the instructions.
(b)
Factors that affect the amount of the monthly fee are [include the]:
(1) monthly costs of the Focused ABA services provided by the contractor as determined by the number of hours of service provided to each eligible child multiplied by the contractor's negotiated hourly rate with HHSC;
(2)
adjusted gross income of the family as determined by the family's federal tax return filed for the previous year,[;] or if the family did not file, the family's gross income minus the allowable deductions [as defined in §105.105 of this chapter (relating to Definitions)];
(3)
family size calculated by adding [summing] the number of parents [or guardians], the child, and other dependents of the parents [or guardians as defined in §105.105 of this chapter]; and
(4)
number of children from a single family who are enrolled in the [HHSC] Children's Autism Program.
(c)
The fee for a single family with multiple children in the Children's Autism Program [service] must be calculated by the contractor for each child monthly. The family will owe 100 percent of the fee amount for the child with the highest fee and 50 percent of each additional child's fee.
[(d) Information about HHSC procedures and the fee schedule used to administer the HHSC Children's Autism Program are available on the HHSC website.]
§358.608.
If [the family has] insurance [that] covers [the] ABA services and an [the in-network provider] agreement exists between the insurance company and the Children’s [HHSC] Autism Program contractor, [requires that] the contractor must accept the deductible, copayment, or coinsurance plus the [and] insurance [reimbursement as] payment as [in] full payment. The [, then the] family's cost share amount must be [is the lesser of] the lower amount of the HHSC Fee Schedule [fee schedule] amount or the insurance deductible, copayment, or coinsurance.
§358.609.
(a)
HHSC funds may [must] not be used to pay [for] any part [portion] of the required cost share.
(b)
When insurance, [To the extent that the family or child is entitled to insurance-payment for services or receives payment for services from] other governmental programs, third-party payers, or [other] private sources provide payment for services other than the required cost share, HHSC funds may [must] not be used [to pay for the services] until all other [methods of] payment options have been used first [applied].
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 April 20, 2026.
TRD-202601681
Karen Ray
Chief Counsel
Health and Human Services Commission
Earliest possible date of adoption: May 31, 2026
For further information, please call: (512) 815-6272