Texas · Proposed rule 22R045 · Comments due Oct 19
HHSC has proposed rewriting 26 TAC Chapter 558. For non-medical PAS agencies that means abuse reports within one hour, SEMARC checks for everyone with client contact, no virtual offices, and no nursing or telehealth. It is not in force yet.
Quick answer
On September 18, 2026, the Texas Health and Human Services Commission (HHSC) published a proposed rewrite of 26 TAC Chapter 558, the licensing rules for home and community support services agencies (51 TexReg 6429, rule project 22R045). It is a proposal and is not in force yet.
For a non-medical personal assistance services (PAS) agency, the biggest proposed changes are: abuse, neglect and exploitation reports to HHSC within one hour instead of 24; SEMARC registry checks for everyone with client contact; a ban on virtual offices written into the rule; no nursing, skilled services or telehealth for PAS-only agencies; and a six-month initial survey deadline that runs even without a payer contract. The license fee stays $2,625 for three years.
Public comments are due by Monday, October 19, 2026.
Status
Checked against official sources on September 30, 2026.
The proposal appeared in the Texas Register, Volume 51, Number 38, on pages 6429 to 6511. HHSC filed it with the Secretary of State on September 2, 2026. It amends 78 sections of Chapter 558, adds 25 new sections and repeals 3, covering licensing, administration, client services, surveys, enforcement and hospice.
HHSC says the purpose is to implement House Bill 1009, House Bill 4696, Senate Bill 240 and Senate Bill 1849 from the 2023 session and Senate Bill 463 from the 2025 session, to streamline how it investigates abuse, neglect and exploitation, and to bring the rules in line with current practice.
Two changes are already happening outside the rule text. Since September 1, 2023, HHSC has asked agencies to report abuse to HHSC only, not DFPS (HCSSA FAQ, p. 24). And since August 3, 2026, agencies must search SEMARC as well as the Nurse Aide Registry (PL 2026-10). The proposal writes both into Chapter 558.
Each change shows the proposed rule text, the current text where it changes, and the policies in a Texas manual that would need updating.
Report to HHSC Complaint and Incident Intake within one hour, down from 24 hours. DFPS is removed from the rule.
Proposed
"the agency must report the alleged ANE to HHSC CII, through the online portal, by calling 1-800-458-9858, or through email immediately but not later than one hour after suspecting or learning of the incident."
In force today
"the agency must report the information immediately, meaning within 24 hours, to: (1) the Department of Family and Protective Services (DFPS) at 1-800-252-5400, or through the DFPS secure website at www.txabusehotline.org; and (2) HHSC at 1-800-458-9858."
Policies to update: 6.1 Reporting abuse, neglect and exploitation
Train every employee, contractor and volunteer on abuse reporting before they start and every year, with two signed acknowledgements. Tell clients how to report at the start of services and every year.
Proposed
"conduct the activities described in paragraphs (2), (3) and (4) of this subsection before an employee, volunteer, or contractor assumes job duties and at least annually thereafter."
Policies to update: 6.1 Reporting abuse, neglect and exploitation; 4.1 Orientation, job training and competency; 2.1 Client rights, conduct and responsibilities
Virtual offices are banned in the rule text. Co-working spaces are allowed if client information stays confidential and surveyors can get in. Home addresses are not mentioned.
Proposed
"An agency must not have a virtual office as its place of business."
Policies to update: 1.1 Operating hours and closed-office notice; 10.1 Client records: use, removal and release
Search SEMARC before hiring or contracting anyone with client contact, and re-check SEMARC, NAR and (if applicable) MAR every 12 months. The Employee Misconduct Registry drops out of the rule text.
Proposed
"Before an agency hires or contracts with any person who may have direct contact with a client, the agency must search the Search Engine for Multi-Agency Reportable Conduct (SEMARC) established under Texas Health and Safety Code Chapter 810 to determine if the person is unemployable."
Policies to update: 3.3 Criminal history checks and registry searches; 3.1 Staffing policies; 3.2 Personnel records
You may hire in an emergency pending the criminal history check if registry searches are clear, but must request the check within 72 hours and document the emergency.
Proposed
"The agency must: (1) request the criminal history check within 72 hours of employment; and (2) maintain documentation of the emergency requiring temporary or interim employment."
Policies to update: 3.3 Criminal history checks and registry searches
PAS agencies may not provide nursing or skilled services. An RN may only assess, delegate and supervise.
Proposed
"An agency providing personal assistance services must not provide nursing or skilled services to its clients."
Policies to update: 5.3 RN delegation of health-related tasks; 2.6 Client care practices
PAS-only agencies may not provide telehealth, telemedicine or telemonitoring.
Proposed
"An agency licensed to provide only personal assistance services must not provide telehealth, telemedicine, or telemonitoring for clients."
Policies to update: 2.6 Client care practices
The six-month deadline runs even if you have no Medicaid or payer contract yet, and HHSC may take enforcement action if you serve no client in six months.
Proposed
"The agency must submit the letter of readiness within six months, regardless of the agency’s ability to obtain payer source authorization or secure a contract for services."
Policies to update: 1.4 Surveyor entry and survey cooperation
Still 8 hours plus the Presurvey Training before designation and 16 within 12 months. It now also covers anyone returning after a break of more than 12 months.
Proposed
"an initial eight hours of educational training in the administration of an agency before designation to the position; and (2) 16 hours of educational training within the first 12 months after being designated to the position;"
Policies to update: 4.2 Administrator training and continuing education
Surrendering a license or letting it expire bars the agency, license holder and affiliates for two years (currently one).
Proposed
"If an agency surrenders the agency’s license or allows the agency’s license to expire without seeking renewal, HHSC will deny any application for a license by the agency, the license holder, and any affiliate for two years starting from the date the license is surrendered or expires."
Policies to update: 1.6 Agency dissolution contingency plan
Agencies with two or more RNs need a workplace violence committee, policies and procedures under Health and Safety Code Chapter 331.
Proposed
"An agency that employs two or more registered nurses must: (A) have a workplace violence prevention committee; (B) develop workplace violence prevention policies and procedures;"
Policies to update: 11.1 Workplace violence prevention
Every agency must designate an infection control officer.
Proposed
"An agency must require the designation of an infection control officer to:"
Policies to update: 7.1 Infection control
CareRulebook maps every Texas policy to the Chapter 558 section it satisfies. Leave your email and we will send your manual preview at launch, plus an alert when HHSC adopts the new rules.
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| Item | Stays as | Source |
|---|---|---|
| License fee | $2,625 for an initial three-year license, and the same for renewal. | 26 TAC §558.3 |
| License term | Three years from the date of issue. | 26 TAC §558.15(b) |
| Home address | Allowed today per the HHSC FAQ. The proposal is silent on home addresses. | HCSSA FAQ p. 8 |
| Administrator training structure | 8 hours before designation, 16 within the first 12 months, 12 hours of continuing education a year. | 26 TAC §558.259, §558.260 |
| Initial survey window | Admit a client and request the initial survey within six months of the license date. | 26 TAC §558.521(a) |
| QAPI committee | Still meets at least twice a year, with tighter documentation of attendance. | 26 TAC §558.287(c) |
Some of these changes already apply through HHSC guidance, so they are worth fixing in your policies today:
The rest depends on the final adopted text, which can change after comments. When HHSC adopts the rules, expect to update your abuse reporting policy to the one-hour window, add annual abuse training with two signed acknowledgements per worker, designate an infection control officer, and check your client care policy for telehealth wording.
YesHHSC allows a home address as the HCSSA place of business, as long as services are directed from there. It must be a real physical place, active client records must be kept there, and someone must let a surveyor in within two hours during business hours.
"Yes. You can use your home address as the HCSSA address if this will be the place of business from which home health, hospice, or PAS is directed."
NoEight hours must be done before designation. The other 16 can be done within the first 12 months. The Presurvey Training is separate and does not count.
"Prior to designation, a first-time administrator or alternate administrator must complete eight clock hours of educational training in the administration of an agency."
NoSince August 3, 2026 HHSC requires SEMARC plus the Nurse Aide Registry, and surveys for it from October 6, 2026.
"These providers will be required to use SEMARC, in addition to the Nurse Aide Registry (NAR), to determine a person’s employability beginning August 3, 2026."
The notice names no individual contact. For questions, it lists (512) 438-3161.
We found these while mapping the proposal against the current rules. They are worth raising in a comment if they affect you.
Proposed §558.249(c) sets a one-hour deadline for abuse reports, but the general definition of "immediately" in §558.2 still means within 24 hours. The acknowledgement staff must sign under new §558.251 uses the word "immediately".
Proposed §558.330(a) limits teleservices to home health and hospice, and "teleservices" includes telecommunications. But other sections let every agency supervise staff or send notices by telecommunications. It is unclear what a PAS-only agency may do remotely.
Proposed §558.244(a)(3) lists administrator qualifications as "at least one of" (A), (B) or (C), "and (D)" presurvey training. Read literally, (D) could be one of the alternatives rather than a requirement.
The fiscal note expects revenue from "security violations" at $100 to $1,000 each, a term the proposed rule text does not use.
The rule in force still says to search the Employee Misconduct Registry, while PL 2026-10 requires SEMARC. It is not stated whether a SEMARC search satisfies the current EMR rule.
Proposed §558.285(b) duties refer to emergency response employees and the client’s designated hospital, which fit clinical settings more than a non-medical PAS agency.
If you apply before the rules are adopted, you are licensed and surveyed under the rules in force at the time, and you will need to update your policies when the new rules take effect. Build your manual so each policy cites the section it satisfies. That makes an update a matter of finding the affected sections rather than rereading the whole manual.
Start with the Texas home care agency guide for the license path, fees, administrator training and the policies Chapter 558 requires.
No. HHSC published it as a proposal in the Texas Register on September 18, 2026 (51 TexReg 6429). It takes effect only after HHSC adopts it and publishes an adoption notice. The notice lists October 18, 2026 as the earliest possible adoption date and states no effective date.
The notice allows comments for 31 days after the September 18, 2026 issue, which makes the last day Monday, October 19, 2026. Emailed comments must be sent before midnight that day, and hand-delivered comments before 5:00 p.m.
Email HHSRulesCoordinationOffice@hhs.texas.gov with the subject line "Comments on Proposed Rule 22R045", or mail it to Rules Coordination Office, P.O. Box 13247, Mail Code 4102, Austin, Texas 78711-3247. HHSC asks for information on the cost, benefit or effect of the rule, and any data or analysis you have.
Under the proposal, immediately but not later than one hour after suspecting or learning of the incident, to HHSC Complaint and Incident Intake. The rule in force today says within 24 hours.
Today, yes: the HHSC FAQ says a home address can be your place of business if services are directed from there. The proposal bans virtual offices and sets conditions for co-working spaces, but it does not mention home addresses.
No. The initial license fee for a parent agency stays $2,625 for a three-year license. The proposal raises only the hospice alternate delivery site fee and removes the old two-year renewal fees.
Now. HHSC Provider Letter PL 2026-10 requires SEMARC plus the Nurse Aide Registry from August 3, 2026, and HHSC surveys for it from October 6, 2026. The proposal writes SEMARC into the rule.
No. Proposed §558.330(b) says an agency licensed to provide only personal assistance services must not provide telehealth, telemedicine or telemonitoring.
No, under both the current rule and the proposal. Eight hours (plus the HHSC Presurvey Training) come before designation, and the other 16 within the first 12 months. The proposal extends the rule to anyone returning after a break of more than 12 months.
You must still submit the letter of readiness for your initial survey within six months, even without a payer contract, and HHSC may take enforcement action if you have not served at least one client.
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