TDLR Health Monitor - June 2023

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Vol. 21 |  June 2023

2023 Legislative Session Recap

sunset capitol

The 88th Regular Session of the Texas Legislature ended with several new state laws affecting TDLR’s Medical and Health Professions programs. Some laws became effective immediately, while others will take effect on September 1, 2023.

TDLR will adopt new or amended rules, as necessary, to implement the new legislation. Some bills include specific direction to TDLR on the rules the agency must adopt and the deadline for adoption. The rulemaking process includes an opportunity to provide comment on proposed rules. The public can participate in the process when proposed rules are published in the Texas Register and at meetings of the Texas Commission of Licensing and Regulation when the rules are discussed and brought up for a vote. The rulemaking process can take several months to complete.

To keep abreast of proposed rule changes, TDLR urges interested parties to sign up for email updates tailored to specific licensing programs. Select "important notices" for the programs of interest.

The following is a selection of new laws affecting TDLR licensees. For a full list, please see the legislation page on the TDLR website.

Health Professions – General

HB 617: Relating to a pilot project to provide emergency telemedicine medical services and telehealth services in rural areas. Effective 9/1/23

SB 490: Relating to itemized billing for health care services and supplies provided by health care providers. Effective 9/1/23

SB 745: Relating to fraud prevention under certain health care programs. Effective 9/1/23

Athletic Trainers

HB 2495: Relating to the requirements to obtain or renew an athletic trainer license. Effective immediately

HB 2512: Relating to the licensing and regulation of athletic trainers. Effective 9/1/23

Dyslexia Therapists

HB 3928: Relating to a student's eligibility for special education services provided by a school district, including services for dyslexia and related disorders. Effective immediately

Hearing Instrument Fitters & Dispensers

SB 2017: Relating to the regulation of hearing aids and the practices of audiology and the fitting and dispensing of hearing instruments. Effective immediately; rules due by 12/1/23

Massage Therapy

HB 2016: Relating to the eligibility requirements for a license as a massage establishment, massage school, massage therapist, or massage therapy instructor. Effective 9/1/23

HB 3579: Relating to the issuance of an emergency order by the Texas Department of Licensing and Regulation against a massage establishment. Effective 9/1/23

SB 483: Relating to the regulation of massage therapy. Effective immediately

SB 1527: Relating to human trafficking, including the prosecution and punishment of compelling and solicitation of prostitution and other sexual or assaultive offenses; increasing a criminal penalty; creating a criminal offense. Effective 9/1/23

Speech-Language Pathologists & Audiologists

SB 2017: Relating to the regulation of hearing aids and the practices of audiology and the fitting and dispensing of hearing instruments. Effective immediately; rules due by 12/1/23

Program Rules Changes

new rules

Midwives Program: Proposed Rules Changes

TDLR has proposed amendments to an existing rule at 16 Texas Administrative Code (TAC) at Chapter 115, §§115.1, 115.4, 115.5, 115.13 – 115.15, 115.20, 115.21, 115.23, 115.25, 115.70, 115.80, 115.100, 115.120, and 115.121; new rules at §§115.2, 115.12, 115.16, 115.22, and 115.121; and the repeal of existing rules at §§115.2, 115.16, and 115.121; regarding the Midwives program. The proposed rules update requirements relating to approval of basic midwifery education courses, preceptor supervision of student clinical experience, informed client choice and disclosure statements, and retired midwife licenses. The proposed rules also make updates to reflect current Department procedures and remove obsolete or unnecessary language.

The proposed rule was published in the April 14, 2023, issue of the Texas Register (48 TexReg 1936), and the public comment period ended on May 15, 2023. The rule proposal will be considered by the Texas Commission of Licensing and Regulation at a meeting in the near future. You can review the rule proposal online.

Behavior Analysts Program: Proposed Rules Withdrawn

The Texas Department of Licensing and Regulation withdraws proposed amendments to existing rules at 16 Texas Administrative Code Chapter 121, Subchapter A, §121.10; Subchapter B, §§121.20-121.22, 121.27, and 121.30; Subchapter D, §121.71 and §121.75; and Subchapter G, §121.90 and §121.95; new rules at Subchapter B, §121.26; Subchapter D, §§121.70 and 121.72-121.74; Subchapter E, §§121.76-121.81; and Subchapter F, §121.85; and the repeal of existing rules at §§121.23, 121.24, 121.26, 121.50, 121.70, and 121.80, regarding the Behavior Analyst program, which appeared in the January 6, 2023, issue of the Texas Register (48 TexReg 9). The withdrawn rule notice was published in the May 12, 2023, issue of the Texas Register (48 TexReg 2475).

Some TDLR Licensees May Need to Provide New Fingerprints for License Renewal

fingerprint cards

State law requires the Texas Department of Licensing and Regulation (TDLR) to conduct a national criminal history background check. As part of that process, TDLR also subscribes to the Federal Bureau of Investigation (FBI) Civil Rap Back Program, which automatically notifies the agency of any arrests or criminal convictions that occur after a licensee is fingerprinted.

Changes to the FBI database require some licensees to submit a new set of fingerprints for TDLR to subscribe to the Civil Rap Back Program and continue to receive reports of arrests and criminal convictions after fingerprinting. Additionally, licensees who have been identified by the FBI as having low-quality fingerprint characteristics will also be required to submit new fingerprints.

TDLR has been working with the Texas Department of Public Safety to identify the TDLR licensees who must submit a new set of fingerprints. Licensees who are impacted by this requirement will be informed by email or mail prior to their next license renewal. Licensees who renew their license after June 1, 2023, and are required to submit new fingerprints, will not be eligible to renew until the fingerprinting process is completed through IdentoGO and the fingerprints are accepted by the FBI Rap Back Program.

To ensure that you will receive communication from TDLR about your license status, please log on to the Online Licensing Services system and verify that the email and mailing addresses we have for you are correct.

If you receive a notice that you are required to submit new fingerprints and you have questions, please contact TDLR via our webform.

Happy Birthday Podiatry and Behavior Analysts Programs!

podiatry 100 years


The Podiatric Medicine Program celebrated its 100th birthday on Wednesday, June 14, 2023.

Back in 1923, the Texas Legislature created the State Board of Chiropody Examiners, which was part of the Texas Board of Medical Examiners, and began regulating #podiatrists. The Texas State Board of Podiatric Medical Examiners eventually became its own agency, and then moved to TDLR in 2017.


Behavior Analysts

TDLR issued the first Behavior Analyst licenses on June 15, 2018 – five years ago.

TDLR staff worked closely with the Behavior Analyst Advisory Board and industry stakeholders to ensure the implementation of the program went smoothly.

The practice of applied behavior analysis is the design, implementation, and evaluation of instructional and environmental modifications to produce socially significant improvements in human behavior.

Podiatrists and Behavior Analysts, we celebrate you and the important work you do!

DEA Requires New Opioid CME Requirements for Prescribers

prescription drug

Attention Podiatrists: The U.S. Drug Enforcement Administration (DEA) is requiring a one-time, eight hour opioid CME course for those individuals applying for a controlled substance prescriber registration as well as those who are renewing their registration. This requirement goes into effect June 27, 2023.

The change was approved in the federal omnibus bill at the end of last year. While the requirement may seem sudden, podiatrists prescribing controlled substances may have already taken acceptable courses. Courses previously taken from a DEA approved provider count towards the DEA’s eight-hour requirement. Courses may be taken live and online and may count toward Texas Podiatric CME requirements. More detailed information from the DEA and links to free courses can be found at: Opioid Awareness Requirement for Continuing Medical Education (

Saving Babies with Texas Newborn Screening

dshs mom

Newborn screening is a critical preventative measure. It allows early identification and treatment of health issues to prevent developmental delays, major illness, or death. Early identification and treatment promotes healthy child development and overall quality of life for newborns and their families. Licensed Midwives who assist at the birth of a child are responsible for performing the newborn screening tests according to the Health and Safety Code, Chapters 33 and 34, and 25 TAC §§37.51 - 37.65, or making a referral according to TAC §115.120 (a)(1-2). If the midwife performs the tests, then she or he must have been appropriately trained.

Each baby born in Texas is screened for 55 rare, but serious disorders or medical conditions. Tests are done using drops of blood taken from a baby’s heel and placed on a card. The first test is collected 24 to 48 hours after birth. The second test is collected at 7-14 days of age. The second test can help identify babies who have conditions that are hard to detect in the first days of life but will still benefit from early treatment and intervention. Babies with abnormal newborn screens require immediate care. 

Each Licensed Midwife must have one of the following documents on file with the department:

  1. Midwife Training Certification Form for Newborn Screening Specimen Collection (if the midwife has completed required training and will perform the screening themselves); or
  2. Newborn Screening Agreement for Newborn Babies of Midwife Clients (if the midwife chooses to refer the family to have the infant's screening done at an appropriate health care facility).

Please view the Texas Department of State Health Services’ (DSHS) video "More Than Drops On a Card” featuring two Texas families. They share their stories emphasizing how important it is to collect timely, good-quality specimens.

For questions regarding newborn screening in Texas, please email DSHS at or call 512-776-7585.

Laser Hair Removal Penalty Matrix Adopted

tdlr penalty matrix

The Texas Commission of Licensing and Regulation adopted the Texas Department of Licensing and Regulation’s (Department) Laser Hair Removal penalty matrix on March 6, 2023. The penalty matrix is part of TDLR’s enforcement plan, which is established in compliance with Texas Occupations Code, §51.302(c).  

The enforcement plan gives all license holders notice of the specific ranges of penalties and license sanctions that apply to specific alleged violations of the statutes and rules enforced by the Department. The enforcement plan also presents the criteria that are considered by Department staff when determining the amount of a proposed administrative penalty or the magnitude of a proposed sanction.

A copy of the enforcement plan is posted on the Department’s website and may be downloaded at Enforcement Plan | You may also contact the Enforcement Division at (512) 539-5600 or by e-mail at to obtain a copy of the plan.

Texas Massage Therapist Exam Now Available in Simplified Chinese

exam laptop glasses pencil answer sheet

Effective June 1, 2023, TDLR now offers the Texas Massage Therapy Examination in Simplified Chinese.

TDLR evaluated the needs of Massage Therapist applicants to determine if an additional language was needed for the Texas Massage Therapy Examination. Using input from the industry and data that tracks the number of requests for translation services, TDLR found that Simplified Chinese was by far the most-requested third language in addition to the current offerings of the examination in English and Spanish.

For more information on this offering, please review the Candidate information Bulletin (CIB) in simplified Chinese on our examination webpage. The CIB provides candidates with information on how to schedule, request accommodations and take the examination. It also provides information regarding the content (topics) of the examination, the passing score required, reference materials the examination uses, and much more.

Reminder: You'll Need To Complete Human Trafficking Awareness Training Before You Can Renew Your License

human trafficking

Before certain health care practitioners can renew their license, they must complete a human trafficking prevention training course approved by the Texas Health and Human Services Commission. This training requirement is a result of House Bill 2059, (86R), which passed in 2019. To learn more about this requirement and view a list of TDLR license types that must comply with this requirement, visit Human Trafficking Prevention Training (

More than 100 training courses are available to choose from, and any of the courses on the HHSC-approved list are acceptable. You may take a free course or complete a course with a fee.

A list of HHSC-approved courses can be found at Health Care Practitioner Human Trafficking Training | Texas Health and Human Services.

TDLR Seeks Members For Advisory Boards

advisory board

TDLR is seeking members for several advisory boards. Members of the boards provide important technical knowledge, industry expertise, and real-world insight regarding their profession to the Texas Commission of Licensing and Regulation (Commission) and TDLR staff. Advisory board members include licensees, representatives from regulated businesses and industries, public members, and other professionals.

Advisory board members are appointed by the chairman with approval of the Commission. There is no financial compensation for membership; however, members who are selected to serve enjoy great satisfaction in knowing the significance of their membership and their impact on the professions they serve.

You may view the list of vacancies at Advisory Board and Committee Vacancies ( If you’re interested in becoming a member of an advisory board or committee, please submit an application. For any questions about the board application process, please contact the Office of Strategic Communication at

Finding Disciplinary Actions

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To find disciplinary actions taken on complaints filed with TDLR, visit the TDLR Administrative Orders Search page.

You can search by name, license number, location, or by program. All disciplinary actions posted on the TDLR website are final actions taken by TDLR. No actions taken by previous licensing boards or agencies are included.

For information on why specific violations of the law or rules might fall into a certain penalty range, please see TDLR's Enforcement Plan.

What about license denials?

License denials and revocations are included. If an application denial is based on criminal history, you can find information on why that criminal history was relevant in the program’s Criminal Conviction Guidelines.

Please take a moment to subscribe to TDLR’s Email Updates to receive important information about programs of interest and upcoming Commission and board meetings, including meeting agendas.

Meet TDLR Staff At Upcoming Conferences

mary hoffman dietetics april 2023

In the coming months, TDLR Health and Wellness staff will be available at several conferences and meetings across Texas to provide licensing and program information to attendees.

We hope to see you at one of these upcoming events:

TDLR is available to provide informational presentations and/or staff booths at your next conference or meeting. If you would like a TDLR representative at your next conference or meeting, send us an email.

Upcoming Advisory Board and Commission Meetings

meeting mics

Commission meetings are in person. Unless otherwise noted, all advisory board meetings are held via videoconference.

You can view the live broadcasts or archived meetings on TDLR's YouTube channel. Meeting notices, agendas, and staff reports are posted on the TDLR Meetings page.