TITLE 25. HEALTH SERVICES
PART 1. DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 1. MISCELLANEOUS PROVISIONS
The executive commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes the repeal of §1.81, concerning Recognition of Out-of-State License of a Military Service Member and Military Spouse, and §1.91, concerning Alternative Licensing for Military Service Members, Military Spouses, and Military Veterans; and new §1.81, concerning Recognition of Out-of-State License of a Military Service Member or Military Spouse, and §1.91, concerning Alternative Licensing for Military Service Members, Military Spouses, and Military Veterans.
BACKGROUND AND PURPOSE
The proposal is necessary to comply with Senate Bill (S.B.) 1818 and House Bill (H.B.) 5629, 89th Regular Session, 2025.
S.B. 1818 amends Texas Occupations 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 §55.0041. 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 Texas Occupations Code §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
Proposed new §1.81 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 new rule revises language for clarity, consistency, plain language, and style. The proposed repeal of §1.81 deletes a rule that is no longer needed because it is being replaced with new §1.81.
Proposed new §1.91 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 new rule revises language for clarity, consistency, plain language, and style. The proposed repeal of §1.91 deletes a rule that is no longer needed because it is being replaced with new §1.91.
FISCAL NOTE
Christy Havel Burton, 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 $30,625 in fiscal year (FY) 2026, $0 in FY 2027, $0 in FY 2028, $0 in FY 2029, and $0 in FY 2030 to DSHS for information technology (IT) enhancements.
GOVERNMENT GROWTH IMPACT STATEMENT
DSHS 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 DSHS 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 DSHS;
(5) the proposed rules will create a new regulation;
(6) the proposed rules will repeal existing regulation;
(7) the proposed rules will increase 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
Christy Havel Burton 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
Dr. Timothy Stevenson, Deputy Commissioner, Consumer Protection Division, 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 DSHS licensure programs in Texas to military service members, military veterans, or military spouses.
Christy Havel Burton 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 amendments will create an economic benefit for military service members, military veterans, and military spouses who are seeking a license in Texas.
TAKINGS IMPACT ASSESSMENT
DSHS 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, TX 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 25R046" in the subject line.
SUBCHAPTER
F.
STATUTORY AUTHORITY
The proposed repeal is authorized by Texas Government Code §524.0151 and Texas Health and Safety Code §1001.075 which authorize the executive commissioner of HHSC to adopt rules and policies for the operation and provision of health and human services by DSHS and for the administration of Texas Health and Safety Code Chapter 1001.
The proposed repeals and new rules implement Texas Government Code §524.0151, Texas Health and Safety Code Chapter 1001, and Texas Occupations Code Chapter 55.
§1.81.
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-202503161
Cynthia Hernandez
General Counsel
Department of State Health Services
Earliest possible date of adoption: October 19, 2025
For further information, please call: (512) 834-6737
25 TAC §1.81
STATUTORY AUTHORITY
The proposed new rule is authorized by Texas Government Code §524.0151 and Texas Health and Safety Code §1001.075 which authorize the executive commissioner of HHSC to adopt rules and policies for the operation and provision of health and human services by DSHS and for the administration of Texas Health and Safety Code Chapter 1001.
The proposed repeals and new rules implement Texas Government Code §524.0151, Texas Health and Safety Code Chapter 1001, and Texas Occupations Code Chapter 55.
§1.81.
(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.
(b) This section applies to all licenses to engage in a business or occupation which the Texas Department of State Health Services (DSHS) 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;
(2) submits an application to DSHS in the manner required by the DSHS rules governing that business or occupation. The department 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;
(C) a notarized affidavit affirming under penalty of perjury that:
(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.
(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 DSHS receives an application under subsection (c)(2) of this section, DSHS notifies the applicant that:
(1) DSHS recognizes the applicant's out-of-state license; or
(2) the application is incomplete; or
(3) DSHS is unable to recognize the applicant's out-of-state license because DSHS 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, DSHS 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 DSHS issues the provisional license.
(h) DSHS reviews and evaluates the following criteria, if relevant to a Texas license, when determining whether another state issues a license that is similar in scope of practice to a license DSHS issues:
(1) the activities the person is authorized to perform under the out-of-state 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;
(3) whether a similar level of supervision or oversight is required under the out-of-state license; and
(4) any other relevant factor.
(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.
(j) 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 by subsection (c)(2) 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.
(k) The military service member or military spouse shall comply with all applicable laws, rules, and standards of Texas, including applicable Texas Health and Safety Code chapters and all relevant Texas Administrative Code provisions.
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-202503159
Cynthia Hernandez
General Counsel
Department of State Health Services
Earliest possible date of adoption: October 19, 2025
For further information, please call: (512) 834-6737
SUBCHAPTER
G.
STATUTORY AUTHORITY
The proposed repeal is authorized by Texas Government Code §524.0151 and Texas Health and Safety Code §1001.075 which authorize the executive commissioner of HHSC to adopt rules and policies for the operation and provision of health and human services by DSHS and for the administration of Texas Health and Safety Code Chapter 1001.
The proposed repeals and new rules implement Texas Government Code §524.0151, Texas Health and Safety Code Chapter 1001, and Texas Occupations Code Chapter 55.
§1.91.
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-202503162
Cynthia Hernandez
General Counsel
Department of State Health Services
Earliest possible date of adoption: October 19, 2025
For further information, please call: (512) 834-6737
25 TAC §1.91
STATUTORY AUTHORITY
The proposed new rule is authorized by Texas Government Code §524.0151 and Texas Health and Safety Code §1001.075 which authorize the executive commissioner of HHSC to adopt rules and policies for the operation and provision of health and human services by DSHS and for the administration of Texas Health and Safety Code Chapter 1001.
The proposed repeals and new rules implement Texas Government Code §524.0151, Texas Health and Safety Code Chapter 1001, and Texas Occupations Code Chapter 55.
§1.91.
(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 Department of State Health Services (DSHS) 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, DSHS 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; or
(2) has had the same Texas license 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) DSHS 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) If an applicant described by subsection (c) of this section must demonstrate competency to meet the requirements for obtaining the license, DSHS may accept alternate forms of competency, including:
(1) proof of a passing score for any national exams required to obtain the occupational license;
(2) proof of duration or hours that meet the professional experience requirement, if specific professional experience is required; and
(3) proof of verified hours related to training experience, if specific training hours are required to obtain the license.
(g) On receipt of a complete application for alternative licensing, DSHS 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 DSHS approves or denies the provisional license holder's license application; or
(2) the 180th day after the date DSHS issues the provisional license.
(i) DSHS has 10 business 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) The department 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-202503160
Cynthia Hernandez
General Counsel
Department of State Health Services
Earliest possible date of adoption: October 19, 2025
For further information, please call: (512) 834-6737