TITLE 25. HEALTH SERVICES

PART 1. DEPARTMENT OF STATE HEALTH SERVICES

CHAPTER 146. TRAINING AND CERTIFICATION OF PROMOTORES OR COMMUNITY HEALTH WORKERS

The executive commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), proposes amendments to §146.1, concerning Definitions; §146.2, concerning Applicability and Exemption; §146.4, concerning Certification of Training Programs; §146.5, concerning Eligibility Requirements and Application Procedures for Community Health Worker Instructors; §146.6, concerning Eligibility Requirements and Application Procedures for Promotores or Community Health Workers; §146.7, concerning Professional and Ethical Standards; and §146.8, concerning Enforcement; and the repeal of §146.3, concerning Promotor(a) or Community Health Worker Training and Certification Advisory Committee.

BACKGROUND AND PURPOSE

The purpose of the proposal is to update Texas Administrative Code (TAC) Chapter 146 to improve clarity and consistency in rule language, codify requirements and standards of Texas Department of State Health Services (DSHS) for certification of CHW training centers, instructors, and promotores, and add references to 25 TAC §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, to allow military service members, military spouses, and veterans to apply for alternative certification or certification exemptions to act as a Community Health Worker (CHW) in Texas. In addition, this proposal repeals 25 TAC §146.3, concerning the Promotor(a) or Community Health Worker Training and Certification Advisory Committee, as this committee was discontinued effective November 4, 2025.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §146.1 updates and clarifies definitions used in Chapter 146. The amendment revises terminology to refer to DSHS, updates several definitions for plain language and clarity, updates the description of core competencies, and removes definitions that are no longer needed, including definitions related to the commission, commissioner, committee, executive commissioner, and program.

The proposed amendment to §146.2 updates applicability and exemption provisions. The amendment clarifies who is subject to the chapter, adds references allowing military service members, military spouses, and military veterans to apply for alternative certification or certification exemptions to act as a CHW in Texas. The amendment references the DSHS website for application forms, instructions, and certification information, and removes a provision related to specialty certification that is no longer included in rule text.

The proposed repeal of §146.3 removes the Promotor(a) or CHW Training and Certification Advisory Committee provisions from Chapter 146 because those provisions are no longer necessary in this chapter. The advisory committee was discontinued effective November 4, 2025.

The proposed amendment to §146.4 updates certification requirements for training programs using plain language. The amendment codifies the standards that DSHS evaluates a training program's curricula and adds where applicants can find application information for certificates.

The proposed amendment to §146.5 updates eligibility requirements and application procedures for CHW instructors using plain language. The amendment also adds standards for certification for persons with disabilities.

The proposed amendment to §146.6 updates eligibility requirements and application procedures for promotores or CHWs for clarity and plain language. The amendment also replaces older department references with DSHS and standards for certification for persons with disabilities.

The proposed amendment to §146.7 updates professional and ethical standards for clarity and plain language. The amendment revises nondiscrimination language and updates continuing education requirements.

The proposed amendment to §146.8 updates enforcement provisions for clarity and plain language. The amendment removes a separate notice provision from rule text, and clarifies the effect of denial, suspension, or revocation on future eligibility for certification.

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, enforcing or administering the rules does not have foreseeable implications relating to costs or revenues of state or local governments.

GOVERNMENT GROWTH IMPACT STATEMENT

DSHS determined during the first five years 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 not create a new regulation;

(6) the proposed rules will expand and repeal existing regulations;

(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 because the proposal primarily updates rule text, terminology, and administrative requirements for certification and renewal.

LOCAL EMPLOYMENT IMPACT

The proposed rules will not affect a local economy.

COSTS TO REGULATED PERSONS

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

PUBLIC BENEFIT AND COSTS

Manda Hall, M.D., Deputy Commissioner, Community Health Improvement Division, has determined that for each year of the first five years the rules are in effect, the public benefit will be clearer and more current rules governing the training and certification of promotores or CHWs, instructors, and training programs.

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 because the proposal primarily updates, clarifies, and reorganizes existing requirements.

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, 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 25R025" 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 Health and Safety Code (HSC) §1001.075, which authorizes the executive commissioner to adopt rules and policies for the operation and provision of health and human services by DSHS and for the administration of HSC Chapter 1001.

The amendments affect Texas Government Code §524.0151 and HSC Chapters 48 and 1001.

§146.1. Definitions.

The following [words and] terms[, when used] in this chapter, [shall] have the following meanings[,] unless the context clearly indicates otherwise.

(1) Applicant--A person who applies to the Texas Department of State Health Services (DSHS) [the department] for a certificate of competency as a promotor(a) or community health worker, an instructor, or a training program.

(2) Certificate--A document [Certificate] issued by DSHS to a promotor(a) or community health worker, instructor, or training program [by the department].

(3) Certified Training Curriculum--An educational plan [, community health training curriculum] approved by DSHS to train [the department for the purpose of training] promotores or community health workers or instructors.

(5) [(7)] Compensation--Financial payment, stipend, or [Receiving payment or receiving] reimbursement for expenses.

(6) [(8)] Core Competencies--The knowledge, skills, and qualities that an individual must demonstrate to be eligible for certification as a community health worker or community health worker instructor under this chapter. The core competencies include: [Key skills for a promotor(a) or community health worker required for certification by the department as listed in policy at www.dshs.texas.gov.]

(7) [(9)] DSHS [Department]--The Texas Department of State Health Services.

(8) [(11)] Instructor--A person certified by DSHS to teach and train promotores or community health workers on [the department to provide instruction and training in] one or more core competencies [to promotores or community health workers].

(9) [(13)] Promotor(a) or Community Health Worker--A person who, with or without compensation, serves as [provides] a liaison between health care providers and patients through activities such as assisting in case conferences, providing patient education, making referrals to health and social services, conducting needs assessments, distributing surveys to identify barriers to health care delivery, making home visits, and providing bilingual language services.

(10) [(14)] Training Program [program]--An organization approved by DSHS to teach and train [the department to deliver a certified training curriculum to] promotores or community health workers or instructors.

§146.2. Applicability and Exemption.

(a) This [The provisions of this] chapter applies [apply] to:

(1) a training program that delivers a DSHS certified training curriculum for promotores or community health workers;

(2) an instructor who [representing that the instructor] trains promotores or community health workers; or

(3) a certified promotor(a) or community health worker [representing that the promotor(a) or community health worker performs as a certified promotor(a) or community health worker].

(b) Certification under this chapter is voluntary for a promotor(a) or community health worker who provides services without receiving compensation and mandatory for a promotor(a) or community health worker who provides services for compensation.

(d) [(c)] DSHS must make application forms, instructions, [Application] and certification information available to the public on the DSHS website [procedures are outlined in policy and can be found online at www.dshs.texas.gov].

§146.4. Certification of Training Programs.

(a) Eligibility [Minimum eligibility] requirements for training programs. The following requirements apply to organizations applying for training program certification:

(1) physical location in Texas;

(2) experience within the past two years in training promotores or community health workers, health care professionals, or paraprofessionals and training [experience within the past two years and] related to the core competencies; and

(3) affiliation with one or more instructors currently certified by DSHS [the department].

(b) Application requirements for training programs. Organizations applying for training program certification must submit: [The department specifies the required information and documentation that an applicant shall complete and notifies the applicant if the application is incomplete.]

(c) [(d)] Denied [Disapproved] applications.

(1) DSHS will deny [The department may disapprove] an application if the applicant:

(A) has not met the eligibility and application requirements for training programs explained in this section [set out in this chapter]; or

(B) has failed or refused to provide the [properly complete or submit] required information or has knowingly presented false or misleading information in the application [process].

(2) [(3)] If an application is denied for reasons other than being [An applicant whose application has been disapproved for a reason other than that it is] incomplete, the applicant may appeal the decision using [disapproval under] the fair hearing procedures found in Chapter 1, Subchapter C of this title (relating to Fair Hearing Procedures).

(d) [(e)] Change [Changes] of name and address. Training programs must [shall] notify the department of changes in organization name, contact information, mailing address, or physical location within 30 calendar days after the change.

(e) [(f)] Certificate.

(1) DSHS will issue a certificate to each approved [Upon approval of the application, the department issues the] training program. The [a] certificate will include the [with an] expiration date and a certificate number.

(2) DSHS [The department] replaces a lost, damaged, or destroyed certificate with [upon] written request to chw@dshs.texas.gov.

(f) [(g)] Standards for [the] approval of certification and continuing education curricula. A training program seeking approval of certification must submit curricula that satisfy the requirements of this section. The curricula must include: [Training programs shall follow the guidelines set in policy regarding standards for certification and continuing education curricula for promotores or community health workers or instructors.]

(g) [(h)] Training program responsibilities. A training program must [shall]:

(1) resubmit revised curricula for certification [submit an addendum, in a format specified by the department and in compliance with policy,] when revising a current, DSHS certified curriculum;

(2) ensure curricula are provided by a certified instructor, unless otherwise approved by DSHS [the department];

(3) provide training to promotores or community health workers or instructors as applicable to the training program's certifications that includes:

(A) at least one certification course per year; and

(B) at least one continuing education course per certification cycle; and

(4) [(5)] maintain a [an accurate] record of each participant's [person's] attendance [and participation] for a minimum of [not less than] three years.

(h) [(i)] Certificate renewal.

(1) A training program must [shall] renew the certificate every two years [in accordance with policy].

(2) Failure to receive renewal notification fromDSHS [the department] before the expiration date will not excuse failure to file for renewal.

(3) [(2)] Failure to meet the requirements in subsection (g)(3) [(h)(3)] of this section will [shall] result in denial of the certificate renewal.

(i) [(j)] Late renewals.

(1) A training program may renew certification within 12 months of the original expiration date [whose certificate has expired for not more than one year may renew the certificate by submitting to the department the completed renewal application]. The training program must [shall] not provide training for community health workers or instructors until the certificate has been renewed. [A certificate not renewed within one year after expiration cannot be renewed.]

(2) A training program with a certification expired for more than 12 months [whose certification has been expired for more than one year] must meet the requirements under subsection (a) of this section and apply for a new certificate.

(j) [(k)] Right to inspect. DSHS [The department] reserves the right to inspect facilities and documentation and to monitor training programs.

§146.5. Eligibility Requirements and Application Procedures for Community Health Worker Instructors.

(a) Eligibility [Minimum eligibility] requirements for instructor certification. The following requirements apply to a person [persons] applying for certification:

(1) Texas residency;

(2) at least 18 years of age;

(3) lack of a physical or mental disability that, consistent [impairment, which in accordance] with the Americans with Disabilities Act, prevents the applicant from safely performing the essential functions of a promotor(a) or community health worker instructor [interferes with the performance of duties or otherwise constitutes a hazard to the health or safety of the persons being served]; and

(4) achievement of core competencies [in instruction or training as identified in policy] through completion of a DSHS-certified 180-hour [certified] competency-based CHW instructor training program within the past three years, or through DSHS [department] verification of at least 1,000 hours related training experience within the past three years.

(b) Application requirements for instructors. A person who wants to be certified as an instructor must submit required documentation such as: [The department specifies the required information and documentation that an applicant shall complete and the department notifies the applicant if the application is incomplete.]

(c) [(d)] Denied [Disapproved] applications.

(1) DSHS [The department] may deny [disapprove] the application if the applicant:

(A) has not met the [eligibility and application] requirements to be an instructor as explained in this section [set out in this chapter];

(B) has not completed or submitted any required information or has provided false or misleading information during [failed or refused to properly complete or submit any required information or has knowingly presented false or misleading information in] the application process;

(C) has engaged in unethical conduct as defined in §146.7 of this chapter (relating to Professional and Ethical Standards);

(D) has been convicted of a felony or misdemeanor directly related to the [duties and] responsibilities of a promotor(a) or community health worker or instructor as explained [set out] in §146.8 of this chapter (relating to Enforcement); or

(2) [(3)] If DSHS denies the application because the eligibility requirements are not met, DSHS sends a letter explaining the denial [the department determines that the application should not be approved because experience requirements are not met, the department gives the applicant written notice of the reason for the disapproval and the opportunity for re-application after sufficient experience is obtained].

(3) [(4)] An applicant with a denied [whose] application [has been disapproved] for a reason not mentioned in paragraph (1) or (2) of this subsection, or because it is incomplete, can appeal the denial under [other than paragraph (2) or (3) in this subsection, may appeal the disapproval under] the fair hearing procedures found in Chapter 1, Subchapter C of this title (relating to Fair Hearing Procedures).

(d) [(e)] Change [Changes] of name and address.

(1) DSHS [The department] changes the status of a certification to inactive if [upon receipt of notification that] the certificate holder no longer lives in Texas.

(2) DSHS certified instructors must notify DSHS of contact information changes and submit legal documentation for [Notification of] name changes [shall be submitted to the department and include a copy of a marriage certificate, court decree evidencing such change, Texas driver's license or identification card, or a social security card reflecting the new name before a certificate or identification card is issued by the department].

(e) [(f)] Certificate.

(1) DSHS will issue a certificate to each approved [The department issues the] instructor. The [a] certificate will include the [with an] expiration date and a certificate number. [An identification card shall be included for a certified instructor.]

(2) DSHS [The department] replaces a lost, damaged, or destroyed certificate or identification card with [upon] written request to chw@dshs.texas.gov.

(f) [(g)] An instructor must work with a DSHS certified [be affiliated with an approved] training program [in order] to provide DSHS certified [department-certified] training to certified promotores or community health workers or instructors.

(g) [(h)] Certificate renewal.

(1) An instructor must [shall] renew certification [the certificate] every two years [in accordance with policy].

(2) Failure to receive renewal notification from DSHS [the department] before the expiration date will not excuse failure to file for renewal.

(3) [(2)] An instructor must complete at least 20 contact hours of continuing education acceptable to DSHS [the department] and related to the core competencies during each certification period.

(4) [(3)] Before certificate expiration, an instructor may request one 90-day extension to complete the continuing education requirement and apply for certificate renewal.

(h) [(i)] Late renewals.

(1) An instructor can renew certification within 12 months after it expires by sending DSHS a [A person whose certificate has expired for not more than one year may renew the certificate by submitting to the department the] completed renewal application. [An instructor must submit proof of compliance with continuing education requirements for renewal as set out in this section before the late renewal is effective. A certificate issued under this subsection shall expire two years from the date the previous certificate expired.]

(2) An instructor with a certification expired for more than 12 months [A person whose certification has been expired for more than one year] must meet the requirements under subsection (a) of this section and apply for a new certificate.

§146.6. Eligibility Requirements and Application Procedures for Promotores or Community Health Workers.

(a) Eligibility [Minimum eligibility] requirements for promotor(a) or community health worker certification. The following requirements apply to a person [persons] applying for certification:

(1) Texas residency;

(2) at least 16 years of age;

(3) lack of a physical or mental disability that, consistent [impairment, which in accordance] with the Americans with Disabilities Act, prevents the applicant from safely performing the essential functions of a promotor(a) or community health worker instructor [interferes with the performance of duties or otherwise constitutes a hazard to the health or safety of the persons being served]; and

(4) achievement of core competencies [identified in policy] through completion of a DSHS-certified 180-hour [certified] competency-based CHW [training provided by an approved] training program within the past three years, or through verification of at least 1,000 hours of related experience within the past three years.

(b) Application requirements for a promotor(a) or community health worker. A person who wants to become a promotor(a) or community health worker must submit required documentation such as: [The department specifies the required information and documentation that an applicant shall complete and the department notifies the applicant if the application is incomplete.]

(c) [(d)] Denied [Disapproved] applications.

(1) DSHS [The department] may deny [disapprove] the application if the applicant:

(A) has not met the eligibility and application requirements for a promotor(a) or community health worker as explained in this section [set out in this chapter];

(B) has not completed or submitted all the required information or has provided false or misleading information during [failed or refused to properly complete or submit any required information or has knowingly presented false or misleading information in] the application process;

(C) has engaged in unethical conduct as defined in §146.7 of this chapter (relating to Professional and Ethical Standards);

(D) has been convicted of a felony or misdemeanor directly related to the job duties and responsibilities of a promotor(a) or community health worker or instructor as explained [set out] in §146.8 of this chapter (relating to Enforcement); or

(2) [(3)] If DSHS denies the application because the eligibility requirements are not met, DSHS sends a letter explaining the denial [the department determines that the application should not be approved because experience requirements are not met, the department gives the applicant written notice of the reason for the disapproval and the opportunity for re-application after sufficient experience is obtained].

(3) [(4)] An applicant with a denied [whose] application [has been disapproved] for a reason not mentioned in paragraph (1) or (2) [other than paragraph (2) or (3)] of this subsection, or because it is incomplete, may appeal the denial using [disapproval under] the fair hearing procedures found in Chapter 1, Subchapter C of this title (relating to Fair Hearing Procedures).

(d) [(e)] Change [Changes] of name and address.

(1) DSHS [The department] changes the status of a certification to inactive if [upon receipt of notification that] the certificate holder no longer lives in Texas.

(2) DSHS certified promotor(a) or community health workers must notify DSHS of contact information changes and submit legal documentation for [Notification of] name changes [must be submitted to the department and include a copy of a marriage certificate, court decree evidencing such change, Texas driver's license or identification card, or a social security card reflecting the new name before a certificate or identification card is issued by the department].

(e) [(f)] Certificate.

(1) DSHS will issue [The department issues] the approved promotor(a) or community health worker a certificate with an expiration date and a certificate number. [An identification card shall be included for a promotor(a) or community health worker.]

(2) DSHS [The department] replaces a lost, damaged, or destroyed certificate or identification card with [upon] written request to chw@dshs.texas.gov.

(f) [(g)] Certificate renewal.

(1) A promotor(a) or community health worker must [shall] renew certification [the certificate] every two years [in accordance with policy].

(2) Failure to receive notification from DSHS [the department] before the expiration date will not excuse failure to file for renewal.

(3) [(2)] A promotor(a) or community health worker must complete at least 20 contact hours of continuing education acceptable to the department and related to the core competencies during each certification period.

(4) [(3)] Before certificate expiration, a promotor(a) or community health worker may request one 90-day extension to complete the continuing education requirement and apply for certificate renewal.

(g) [(h)] Late renewals.

(1) A promotor(a) or community health worker can renew certification within 12 months after it expires by sending DSHS a [A person whose certificate has expired for not more than one year may renew the certificate by submitting to the department the] completed renewal application. [A promotor(a) or community health worker must also submit proof of compliance with continuing education requirements for renewal as set out in this section before the late renewal is effective. A certificate issued under this subsection shall expire two years from the date the previous certificate expired.]

(2) A promotor(a) or community health worker with a certification expired for more than 12 months [A person whose certification has been expired for more than one year] must meet the requirements under subsection (a) of this section and apply for a new certificate.

§146.7. Professional and Ethical Standards.

[(a)] A certified training program, instructor, and promotor(a) or community health worker must follow [shall observe and comply with] the professional and ethical standards of practice [set forth] in this chapter [subchapter]. A violation of the professional and ethical standards constitutes unethical conduct or conduct that discredits or tends to discredit the profession of promotores or community health workers or instructors and is grounds for disciplinary action.

(1) Professional representation and responsibilities.

(A) An instructor or promotor(a) or community health worker must [shall] not misrepresent any professional qualifications or credentials or provide any information that is false, deceptive, or misleading.

(B) An instructor or promotor(a) or community health worker must [shall] not engage in conduct that is prohibited by state, federal, or local law, including those laws prohibiting the use, possession, or distribution of drugs or alcohol.

(C) An instructor or promotor(a) or community health worker must [shall] not discriminate based on race, creed, sex, [gender, sexual orientation,] religion, national origin, age, physical disability, or economic status in the performance of community health work services or training.

(D) An instructor or promotor(a) or community health worker must [shall] maintain knowledge and skills for continuing professional competence by participating in continuing education [programs] and activities that cover at least one core competency and meet the applicable requirements in §146.5(g)(3) [as set out in §146.5(h)(2)] of this chapter (relating to Eligibility Requirements and Application Procedures for Community Health Worker Instructors) and §146.6(f)(3) [§146.6(g)(2)] of this chapter (relating to Eligibility Requirements and Application Procedures for Promotores or Community Health Workers)[, concerning continuing education requirements].

(E) An instructor or promotor(a) or community health worker must not provide [shall refrain from providing] services that are outside the scope of the profession and must [shall] refer a client for [those] services [that] the instructor or promotor(a) or community health worker is unable to provide [meet].

(F) An instructor or promotor(a) or community health worker must [shall be responsible for competent and efficient performance of the instructor or promotor(a) or community health worker assigned duties and shall] report [to the department] incompetence and illegal or unethical conduct of members of the profession to DSHS.

(G) An instructor or promotor(a) or community health worker must [shall] not retaliate against any person who reports [reported] in good faith [to the department] alleged incompetence; misrepresentation; or illegal, unethical, or negligent conduct of any instructor or promotor(a) or community health worker to DSHS.

(H) [(I)] A training program must [shall] not make any misleading, deceptive, or false representation in connection with offering or obtaining approval of a DSHS certified curriculum.

(I) [(J)] A DSHS certified training program must [of a certified curriculum shall] not discriminate in decisions regarding student recruitment, selection of applicants, training, or instruction based on race, creed, sex, [gender, sexual orientation,] religion, national origin, age, physical disability, or economic status.

(2) Relationships with clients.

(A) An instructor or promotor(a) or community health worker must [shall] not accept gifts or money [gratuities] for preferential consideration of a [the] client. The instructor or promotor(a) or community health worker must avoid [shall guard against] conflicts of interest.

(B) An instructor or promotor(a) or community health worker must [shall] not violate any [provision of any] federal or state statute or regulation relating to confidentiality of client communication and records.

§146.8. Enforcement.

(a) DSHS [The department] may deny [disapprove], suspend, or revoke a certification if the applicant or certification holder:

(1) has been convicted of a felony or misdemeanor that relates to the job [a criminal conviction that relates to the duties and responsibilities] of a training program, instructor, or promotor(a) or community health worker and DSHS will consider [, based on]:

(A) the nature and seriousness of the crime;

(B) the length of time since the crime occurred;

(C) how the certification may have facilitated the crime; and

(D) the extent to which certification could create an opportunity to engage in further criminal activity of a similar nature;

(2) falsely represents to be [oneself as] a certified training program, instructor, or promotor(a) or community health worker without a certification issued under this chapter;

(3) obtains or attempts to obtain a certification under this chapter using false information or through bribery;

(4) violates §146.7 of this chapter (relating to Professional and Ethical Standards); or

(5) has a certification in another jurisdiction denied, revoked, suspended, or otherwise subjected to adverse action.

(b) In determining enforcement under this section, DSHS [the department] considers:

(1) the pattern of behavior and severity of the violation;

(2) the length of time since the violation occurred;

(3) any potential harm to the public; and

(4) any previous violation by the applicant or certification holder.

(c) [(d)] A training program, instructor, or promotor(a) or community health worker [A person] whose certificate is denied, suspended, [disapproved] or revoked [under this section] is ineligible for a certificate [under this chapter] for two years from the date of the denial, suspension, [disapproval] or revocation. Upon denial [disapproval], suspension, or revocation, the certificate holder must [shall] return a certificate or an identification card to DSHS [the department].

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 9, 2026.

TRD-202603923

Cynthia Hernandez

General Counsel

Department of State Health Services

Earliest possible date of adoption: October 25, 2026

For further information, please call: (512) 915-8078

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; Texas Health and Safety Code (HSC) §1001.075, which authorizes the executive commissioner to adopt rules and policies for the operation and provision of health and human services by DSHS and for the administration of HSC Chapter 1001.

The repeal affects Texas Government Code §524.0151 and HSC Chapters 48 and 1001.

§146.3. Promotor(a) or Community Health Worker Training and Certification Advisory Committee.

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 9, 2026.

TRD-202603922

Cynthia Hernandez

General Counsel

Department of State Health Services

Earliest possible date of adoption: October 25, 2026

For further information, please call: (512) 915-8078