TITLE 1. ADMINISTRATION

PART 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION

CHAPTER 351. COORDINATED PLANNING AND DELIVERY OF HEALTH AND HUMAN SERVICES

SUBCHAPTER A. GENERAL PROVISIONS

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

BACKGROUND AND PURPOSE

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

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

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

SECTION-BY-SECTION SUMMARY

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

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

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, limit, 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. The rules do not impose any additional costs on small businesses, micro-businesses, or rural communities that are 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 do not impose a cost on regulated persons; are amended to reduce the burden or responsibilities imposed on regulated persons by the rules; are amended to decrease a person's cost for compliance with the rules; and are necessary to implement legislation that does not specifically state that §2001.0045 applies to the rules.

PUBLIC BENEFIT AND COSTS

Lisa Glenn, Deputy Chief Policy and Regulatory Officer and Interim Deputy Executive Commissioner for Regulatory Services, has determined that for each year of the first five years the rules are in effect, the public benefit will be an increase in the availability of additional licenses issued by HHSC licensure programs in Texas to military service members, military veterans, or military spouses.

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. Instead, the rules will create an economic benefit for military service members, military veterans, and military spouses who are seeking a license in Texas.

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 25R050" in the subject line.

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; Texas Occupations Code §55.004, which requires a state agency that issues a license to adopt rules for the issuance of the license to an applicant who is a military service member, military veteran, or military spouse; and Texas Occupations Code §55.0041, requires a state agency that issues a license to adopt rules for recognition of out-of-state licenses of military service members and military spouses.

The amendments implement Texas Government Code §524.0151 and Texas Occupations Code Chapter 55.

§351.3. Recognition of Out-of-State License of a Military Service Member or Military Spouse [~~Members and Military Spouses~~].

(a) This section uses the same definitions as found in Texas Occupations Code Chapter 55. The requirements and steps in this section follow what Texas Occupations Code Chapter 55 allows or requires. This section does not change or affect any rights given by federal law.

[(a) For the purposes of this section, the definitions found in Texas Occupations Code §55.001 are hereby adopted by reference. This section establishes requirements and procedures authorized or required by Texas Occupations Code, Chapter 55, and does not modify or alter rights that may be provided under federal law.]

(b) This section applies to all licenses to engage in a business or occupation which the Texas Health and Human Services Commission (HHSC) issues to an individual under authority granted by the laws of the State of Texas. A more specific rule concerning recognition of out-of-state licenses of military service members and military spouses may also apply but only to the extent the more specific rule does not conflict with this rule. Any conflicts between this rule and the more specific rule are resolved in favor of this rule.

(c) A military service member or military spouse may engage in a business or occupation as if licensed in the State of Texas without obtaining the applicable license in Texas if the military service member or military spouse:

(1) currently holds a license similar in scope of practice issued by the licensing authority of another state and is in good standing with that state's licensing authority [~~is currently licensed in good standing with another jurisdiction that has licensing requirements substantially equivalent to the requirements of a license in this state~~]; and

(2) submits an application to HHSC in the manner required by the HHSC rules governing that business or occupation. HHSC does not charge any application fees, but the applicant may still be responsible for paying costs to third-party vendors, such as costs for criminal background checks. The application must include:

(A) a copy of the member's military orders showing relocation to Texas;

(B) a copy of the military spouse's marriage license, if the applicant is a military spouse; and

(i) the applicant is the person described and identified in the application;

(ii) all statements in the application are true, correct, and complete;

(iii) the applicant understands the scope of practice for the applicable license in Texas and will not perform outside of that scope of practice; and

(iv) the applicant is in good standing, as defined by subsection (d) of this section, in each state in which the applicant holds or has held an applicable license.

~~[(2) notifies HHSC in writing of the military service member's or military spouse's intent to practice in this state;]~~

[(3) submits to HHSC proof of the military service member's or military spouse's residency in this state and a copy of the military service member's or military spouse's military identification card; and]

[(4) receives a verification letter from HHSC that:]

[(A) HHSC has verified the military service member's or military spouse's license in another jurisdiction; and]

[(B) the military service member or military spouse is authorized to engage in the business or occupation in accordance with Texas Occupations Code §55.0041 and rules for that business or occupation.]

(d) For purposes of this section, a person is in good standing with another state's licensing authority if the person:

(1) holds a license that is current, has not been suspended or revoked, and has not been voluntarily surrendered during an investigation for unprofessional conduct;

(2) has not been disciplined by the licensing authority with respect to the license or person's practice of the occupation for which the license is issued; and

(3) is not currently under investigation by the licensing authority for unprofessional conduct related to the person's license or profession.

(e) Not later than the 10th business day after HHSC receives an application under subsection (c)(2) of this section, HHSC notifies the applicant that:

(1) HHSC recognizes the applicant's out-of-state license;

(2) the application is incomplete; or

(3) HHSC is unable to recognize the applicant's out-of-state license because HHSC does not issue a license similar in scope of practice to the applicant's license.

(f) On receipt of the information required by subsection (c)(2) of this section, HHSC issues a provisional license to the applicant.

(g) A provisional license issued under subsection (f) of this section may not be renewed. The provisional license expires on the earlier of:

(1) the date the agency issues or denies the recognition under subsection (e) of this section; or

(2) the 180th day after the date HHSC issues the provisional license.

(h) [~~(d)~~] HHSC reviews [~~will review~~] and evaluates [~~evaluate~~] the following criteria, if relevant to a Texas license, when determining whether another state issues a license that is similar in scope of practice [~~state's licensing requirements are substantially equivalent~~] to [~~the requirements for~~] a license HHSC issues [~~under the statutes and regulations of this state~~]:

(1) the activities the person is authorized to perform under the out-of-state license;

~~[(1) whether the other state requires an applicant to pass an examination that demonstrates competence in the field to obtain the license;]~~

(2) whether the out-of-state license authorizes the person to work with a similar population and in a similar setting as a Texas license;

~~[(2) whether the other state requires an applicant to meet any experience qualifications to obtain the license;]~~

(3) whether a similar level of supervision or oversight is required under the out-of-state license; and

~~[(3) whether the other state requires an applicant to meet any education qualifications to obtain the license; and]~~

(4) any other relevant factor.

~~[(4) the other state's license requirements, including the scope of work authorized to be performed under the license issued by the other state.]~~

[(e) The military service member or military spouse must submit:]

[(1) a written request to HHSC for recognition of the military service member's or military spouse's license issued by the other state; no fee will be required;]

[(2) any form and additional information regarding the license issued by the other state required by the rules of the specific program or division within HHSC that licenses the business or occupation;]

[(3) proof of residency in this state, which may include a copy of the permanent change-of-station order for the military service member;]

[(4) a copy of the military service member's or military spouse's identification card; and]

[(5) proof the military service member or, with respect to a military spouse, the military service member to whom the spouse is married is stationed at a military installation in Texas.]

(i) A military service member or military spouse may engage in the business or occupation under the authority of this section only for the period during which the military service member or, with respect to a military spouse, the military service member to whom the spouse is married is stationed at a military installation in Texas.

[(f) HHSC has 30 days from the date a military service member or military spouse submits the information required by subsection (e) of this section to:]

[(1) verify that the member or spouse is licensed in good standing in a jurisdiction that has licensing requirements that are substantially equivalent to the requirements for a license under the statutes and regulations of this state; and]

[(2) issue a verification letter recognizing the licensure as the equivalent license in this state.]

[(g) The verification letter will expire three years from date of issuance or when the military service member or, with respect to a military spouse, the military service member to whom the spouse is married is no longer stationed at a military installation in Texas, whichever comes first. The verification letter may not be renewed.]

(j) [~~(h)~~] In the event of a divorce or similar event that affects a person's status as a military spouse, the former spouse may continue to engage in the business or occupation under the authority of this section until the third anniversary of the date the spouse submitted the application required [~~received the verification described~~] by subsection (c)(2) [ ~~(f)~~] of this section. A similar event includes the death of the military service member or the military service member's discharge from the military. If the former spouse decides to keep practicing in Texas, the former spouse must obtain a Texas license.

[(i) A replacement letter may be issued after receiving a request for a replacement letter in writing or on a form, if any, required by the rules of the specific program or division within HHSC that licenses the business or occupation; no fee will be required.]

(k) [~~(j)~~] The military service member or military spouse shall comply with all applicable laws, rules, and standards of Texas [~~this state~~], including applicable Texas Health and Safety Code chapters and all relevant Texas Administrative Code provisions.

[(k) HHSC may withdraw or modify the verification letter for reasons including the following:]

[(1) the military service member or military spouse fails to comply with subsection (j) of this section; or]

[(2) the military service member's or military spouse's licensure required under subsection (c)(1) of this section expires or is suspended or revoked in another jurisdiction.]

§351.6. Alternative Licensing for Military Service Members, Military Spouses, and Military Veterans.

(a) This section uses the definitions in Texas Occupations Code (TOC) Chapter 55. This section makes rules based on TOC Chapter 55 and does not change or affect rights under federal law.

(b) This section applies to all licenses to engage in a business or occupation which the Texas Health and Human Services Commission (HHSC) issues to an individual under authority granted by the laws of the State of Texas. A more specific rule concerning alternative licensing for military service members, military spouses, and military veterans may also apply but only to the extent the more specific rule does not conflict with this rule. Any conflicts between this rule and the more specific rule are resolved in favor of this rule.

(c) Notwithstanding any other rule, HHSC may issue a license or provisional license to an applicant who is a military service member, military spouse, or military veteran if the military service member, military spouse, or military veteran:

(1) holds a current license issued by another state that is similar in scope of practice to the license in Texas and is in good standing, as defined by subsection (d) of this section, with that state's licensing authority [~~is currently licensed in good standing with another jurisdiction that has licensing requirements substantially equivalent to the requirements of a license in this state~~]; or

(2) has had [~~held~~] the same Texas license [~~in Texas~~] within the preceding five years.

(d) For purposes of this section, a person is in good standing with another state's licensing authority if the person:

(1) holds a license that is current, has not been suspended or revoked, and has not been voluntarily surrendered during an investigation for unprofessional conduct;

(2) has not been disciplined by the licensing authority with respect to the license or person's practice of the occupation for which the license is issued; and

(3) is not currently under investigation by the licensing authority for unprofessional conduct related to the person's license or profession.

(e) [~~(d)~~] HHSC may waive any requirement to obtaining a license for an applicant described by subsection (c) of this section after reviewing the applicant's credentials.

(f) [~~(e)~~] If an applicant described by subsection (c) of this section must demonstrate competency to meet the requirements for obtaining the license, HHSC may accept alternate forms of competency including:

(1) proof of a passing score for any national exams required to obtain the occupational license;

(2) [~~if specific professional experience is required,~~] proof of duration or hours that meet the professional experience requirement, if specific professional experience is required; and

(3) [~~if specific training hours are required for obtaining the license,~~] proof of verified hours related to training experience, if specific training hours are required to obtain the license.

[(f) If required by the specific program or division within HHSC that licenses the business or occupation, a military service member or military spouse must provide proof of residency in this state, which may include a copy of the permanent change-of-station order for the military service member or any other documentation HHSC deems appropriate to verify residency.]

(g) On receipt of a completed application for alternative licensing, HHSC issues a provisional license pending the issuance of a license. A provisional license may not be renewed.

(h) A provisional license issued under subsection (g) of this section expires on the earlier of:

(1) the date HHSC approves or denies the provisional license holder's license application; or

(2) the 180th day after the date HHSC issues the provisional license.

(i) [~~(g)~~] HHSC has 10 business [30] days from the date a military service member, military spouse, or military veteran submits an application for alternative licensing to process the application and issue a license to an applicant who qualifies for the license.

(j) HHSC does not charge for the license. However, the applicant is responsible for any required costs paid to third-party vendors, such as costs for criminal background checks.

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 September 5, 2025.

TRD-202503163

Karen Ray

Chief Counsel

Texas Health and Human Services Commission

Earliest possible date of adoption: October 19, 2025

For further information, please call: (512) 221-9021