Hello, Health Professions Licensees,

TDLR has had a hectic summer since we last touched base with you in June: among other legislation passed during the regular session of the Texas Legislature, we were entrusted with stewardship of the Texas Lottery and Charitable Bingo programs. As you might imagine, bringing on two new programs as large as the Lottery and Charitable Bingo has been labor-intensive but we've risen to the challenge.

Our history shows that when it comes to efficient and effective state government, the Texas Legislature looks to us as problem solvers. Please rest assured that providing efficient and innovative licensing services will continue to be at the core of what we do. 

As part of our mission to provide efficient and innovative licensing services, we need your help. Please take a moment to read two articles in this month's issue of the Health Monitor:

We are seeking subject matter experts to assist our Enforcement Prosecutors in the following areas:

• Dyslexia Therapists
• Hearing Instrument Fitters and Dispensers
• Podiatric Medicine
• Orthotists and Prosthetists

And we're looking for volunteers to serve on the following advisory boards:

• Behavior Analyst Advisory Board: one public member
• Hearing Instrument Fitters and Dispensers Advisory Board: a Doctor of Otolaryngology and two public members
• Massage Therapy Advisory Board: two members who represent licensed massage schools and a member who is a peace officer with expertise in the enforcement of human trafficking and prostitution cases
• Orthotists and Prosthetists Advisory Board: a prosthetist and a public member who uses an orthosis

Please consider serving either as a subject matter expert or as a member of one of our advisory boards - both of these are excellent ways to serve your profession. Thanks for all you do.

Courtney Arbour

Executive Director

The Texas Commission of Licensing and Regulation (Commission) met on September 26, 2025 and adopted new rules for the Laser Hair Removal program at 16 Texas Administrative Code (TAC), Chapter 118, Subchapter A, §§118.1-118.4; Subchapter B, §§118.10-118.14; Subchapter C, §§118.20-118.29; Subchapter D, §118.30; Subchapter E, §118.40; Subchapter F, §118.50 and §118.51; Subchapter G, §118.60 and §118.61; Subchapter H, §118.70; Subchapter I, §§118.80 and §118.81; and adopted the repeal of existing rules at §§118.1-118.3, §118.10, §118.20, §§118.30-118.35, §118.40, §118.50, §118.60, §118.61, §118.70, §118.71, §118.80, §118.90, §118.91, §118.100, §118.110, with the addition of subchapters to an existing chapter, regarding the Laser Hair Removal program.

The newly adopted rules include changes recommended by Department staff during the four-year rule review process to reorganize and streamline the entire chapter by consolidating the existing rules, reorganizing provisions by subject matter, eliminating duplicative provisions, and applying plain language principles to improve clarity.

The adopted new rules for TAC Chapter 118 Laser Hair Removal went into effect on October 1, 2025.

The Texas Department of Licensing and Regulation (Department) is reviewing multiple health professions program rules located at Title 16, Texas Administrative Code. This rule review is required every four years.

The Notice of Intent to Review was published in the Texas Register on August 15, 2025 (50 TexReg 5346 for the following programs:

Behavior Analyst rules, located at Title 16, Economic Regulation, Chapter 121

Massage Therapy rules, located at Title 16, Economic Regulation, Chapter 117

Podiatry rules, located at Title 16, Texas Administrative Code, Chapter 130

The Department will determine whether the reasons for adopting or readopting these rules continue to exist by answering the following questions for each rule:

• Is it obsolete?
• Does it reflect current legal and policy considerations?
• Is it in alignment with the current procedures of the Department?

You can stay up to date on the rule review process via each program’s webpage. You can also sign up for email updates here.

The Department of State Health Services (DSHS) proposed rule (Texas Administrative Code, Title 25, Chapter 37) relating to Vision, Hearing, and Spinal Screenings is open for comments now through November 10th.

These proposed changes include updates to audiometer requirements and the addition of an optional hearing screening method. Your valuable input helps shape policies that impact your profession and people living in Texas.

Please review the draft rule and send any comments you'd like to share to the HHS Rules Coordination Office (not TDLR).

The Speech-Language Pathologists and Audiologists Advisory Board met on July 28, 2025, and recommended adoption of proposed rules by the Texas Commission of Licensing and Regulation. If the proposed rules are adopted by the Commission on October 28, 2025, there will be several updates to the Speech-Language Pathology and Audiology program. Most of these changes are intended to streamline the application process, reduce paperwork, and make licensing more efficient.

While many updates are being proposed, one major change will directly affect all speech-language pathology assistants (SLP assistants) and their approved speech-language pathologist (SLP) supervisors. Currently, applicants must submit proof of completing 50 hours of clinical observation and clinical assisting experience while enrolled in their university program when they apply for their SLP assistant license. Because most universities no longer provide all 50 hours, many applicants have been required to complete a Clinical Deficiency Plan (CDP) with their license application which outlines how they will obtain the missing hours after licensure. The CDP is reviewed by TDLR and, if approved, the SLP assistant will work under their CDP once their license is issued until all missing hours are complete. This process has added extra steps and paperwork.

Under the proposed rules, the clinical deficiency plan will be eliminated. If an applicant did not complete their 50 hours of required clinical observation and clinical assisting experience through their university, the missing hours must be completed under 100% direct supervision by the approved supervising SLP after the SLP assistant license is issued. The supervising SLP will be responsible for ensuring all missing hours are completed under direct supervision before allowing the SLP assistant to practice without 100% direct supervision.

For more information: Summary of Proposed Rule Changes | TDLR News and Updates

On July 8, 2025, the Texas Commission of Licensing and Regulation met and approved the following advisory board member appointments and reappointments:

• Amy Wood was reappointed to the Behavior Analyst Advisory Board and Mariel Fernandez was appointed as Presiding Officer.
• Diana Bueno was appointed to the Dyslexia Therapists and Practitioners Advisory Board.
• Matthew Toohey was appointed to Hearing Instrument Fitters and Dispensers Advisory Board
• Destiny Hooper was appointed as the Presiding Officer to the Midwives Advisory Board.

Licensed Hearing Instrument Fitters and Dispensers now have a new way to earn continuing education (CE) credit—by serving as proctors for the practical licensing test. This opportunity comes with updates to TAC §112.70, effective January 1, 2024.

Proctors earn one CE hour per test date, with a maximum of four hours per two-year license term. To qualify, licensees must be in good standing, have held their license for at least two years, and have observed three full test sessions.

Proctors also receive $200 per test day and mileage reimbursement for out-of-town travel. It’s a meaningful way to support the profession while earning CE credit. If you're interested in participating, please visit our website for more information.

TDLR is working hard on creating a new licensing system called CORE because licensing is the core of everything we do! CORE will replace the nine different systems we currently use to license our 41 different programs and be the backbone of TDLR for years to come. 

The new system is being assembled and programmed in waves. The Behavior Analysts program is scheduled for Wave 2, so be on the lookout for updates soon. The system is being developed with all agency staff involved in different aspects and an outside vendor called CGI, who is leading the programming part. We are very excited to be able to serve you better with this new system!

As the switchover approaches, we will send out notifications via email with instructions and short videos on how to use the new system, as well as updates to our website. Stay tuned!

TDLR enforcement prosecutors need your help filling the role of Subject Matter Experts (SMEs).

We are seeking SMEs in the following areas:

• Dyslexia Therapists
• Hearing Instrument Fitters and Dispensers
• Podiatric Medicine
• Orthotists and Prosthetists

Subject matter experts (SMEs) review complaint cases, generally involving standard of care issues, to assist our Enforcement Division during the investigation process.

If you are interested in becoming a Subject Matter Expert, please complete the Expert Witness Application. Once the application is submitted, Enforcement Division staff will follow up with a detailed questionnaire.

All SMEs receive training on their role in reviewing complaint cases. Tasks may include:

• Reviewing documents and statements collected by investigators;
• Writing a report stating an opinion as to whether the respondent violated a law or rule in the provision of care to a client;
• Answering specific questions from the prosecutor about the case; and/or
• Testifying as a witness for TDLR at hearings.

Our mission is to protect the citizens of Texas and the hard-working members of your profession. We cannot do that without your specialized knowledge of the complexities of your profession. Please consider becoming a SME today.

The Legislature passed Senate Bill 541 (SB 541) during this year’s session, expanding who can offer health care services through a Direct Patient Care Agreement. 

The bill amends Subchapter F of Occupations Code 162, renaming it and moving it to Chapter 117 titled Direct Patient Care. Previously, this model applied only to physicians, but now it is available to a broader range of licensed health care professionals.

This model of care functions like a membership or subscription, except instead of a gym, it’s a health care provider you are visiting. The provider and patient enter into a contract for a set number of services or visits, for a specific amount of time, at a fixed price. Providers must clearly inform patients that their insurance will not cover these fees. Additionally, providers cannot bill insurance for any services covered under a direct patient care contract. Doing so would constitute double billing and that is considered fraud.  

TDLR is authorized to enforce this new law under existing rules within each program. The new law went into effect on Sept 1, 2025.  

More information will be shared through webpage updates, social media, and articles like this!

October is National Audiology Awareness Month, making it the perfect time to explore changes that can improve your quality of life for a better tomorrow. Established by the American Academy of Audiology (AAA) in 2008, National Audiology Awareness Month aims to raise public awareness about noise-induced hearing loss, promote prevention strategies, and educate the public about the vital role audiologists play in maintaining healthy hearing. Whether through preventative care or treating hearing loss, audiologists are essential partners in helping individuals live life to the fullest.

October is National Dyslexia Awareness Month, a time when communities across the country come together to highlight the needs, challenges, and signs of dyslexia. This month-long observance aims to raise awareness about dyslexia, a learning disorder that affects how individuals process language. Importantly, dyslexia does not impact intelligence. However misunderstandings about the condition often lead to stigmas, which Dyslexia Awareness Month aims to eliminate. That's why it's important to spread awareness and educate others about dyslexia. 

October includes National Massage Therapy Awareness Week.  American Massage Therapy Association’s (AMTA) Annual National Massage Therapy Awareness Week® (NMTAW) will take place October 19-25, 2024. This is a dedicated week for massage therapists across the U.S. to promote the health benefits of massage therapy and their practices. For ways to help celebrate Massage Therapy Awareness Week, visit AMTA’s website.

Do you need a verification of your license? You can do that online!

The link can be found on the top of the TDLR home page, on each profession’s program webpage, or you can go directly to the license verification page.

You can search for a license by name, profession, or license number. It’s quick, easy, and always available!

TDLR is looking for individuals to join advisory boards and committees. Advisory boards are instrumental in what we do at TDLR. They are experts in their field and help us update and create rules for their programs, revise the enforcement penalty matrix, and may serve as subject matter experts for TDLR. You may also be eligible to serve as a public member on other program boards, beyond your own. Most boards usually meet virtually one to two times a year. 

If you are interested in becoming a member of an advisory board submit an application.

For more information, please email advisory.boards@tdlr.texas.gov. 

Behavior Analyst Advisory Board 6-year term

• Public Member

Hearing Instrument Fitters and Dispensers Advisory Board 6-year term

• Doctor of Otolaryngology
• Public Member
• Public Member*

*Term Expires: 02/01/2029 — appointee will finish out the unexpired portion of a previously appointed term

Massage Therapy Advisory Board 6-year term

• Member who represents a licensed massage school
• Member who represents a licensed massage school Term Expires: 09/01/2029 — appointee will finish out the unexpired portion of a previously appointed term
• Member who is a peace officer with expertise in the enforcement of Human Trafficking and Prostitution

Orthotists and Prosthetists Advisory Board 6-year term

• Prosthetist
• Public Member who uses an orthosis

TDLR’s Medical and Health Professions staff is gearing up for the end of year and next year’s conferences. We hope to see you at our upcoming events!  We’ll be available to answer questions and provide information to attendees.

• Texas Speech Language Hearing Association: Thursday, February 19 – Saturday, February 21 in Fort Worth.

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, contact us at Compliance.Health.Professions@tdlr.texas.gov.