Highlights of Legislative Update and Budget Details

Legislative Update

Bill Statistics Total # of bills (HBs, SBs, HJRs, SJRs) filed: 9,014 Total # of bills that DSHS tracked: 1,102 Total # of bills sent to/signed by the Governor: 1,183 Subset of DSHS tracked bills that have be sent to/signed by the Governor: 155

SB 1 The Budget & Exceptional Items Highlights

Budget Highlights Emergency Medical Task Force (EMTF) (Rider 23) Funded at $10M to support ongoing programs, exercises, and readiness for the EMTF $3M of this will go to the replacement of critical emergency medical response equipment statewide including emergency vehicles, trailers, and durable medical equipment HIV Injectable Treatment (Rider 31) New pilot program that is funded at $600K to provide long-lasting HIV injectable treatment for up to 210 clients eligible for ADAP Spay and Neuter Pilot Program (Rider 32) DSHS will implement a $13M pilot program focused on reducing the population of cats and dogs at risk for unplanned breeding

Budget Highlights Whole Blood Pilot Program (Rider 35) $10M from GR to establish a program to support EMS agencies in administering whole blood to patients in the field suffering from extreme blood loss DSHS will consult with Regional Advisory Councils to determine the most cost-effective method Report due on 11/1/26 will detail the list of awardees, areas served by the grant funds, challenges identified, and reported outcomes Future Healthcare Workforce Apprenticeship Support (Rider 36) New rider with $1M in General Revenue to provide grants to hospitals to develop and implement on-site healthcare workforce apprenticeship programs and prepare a report to post on the website that identifies the hospitals that are participating, number of apprenticeships and their specialty area

Full EIs

Exceptional Items Exceptional Item 1, Meet Increased Costs for Current Agency Operations o Vehicles HB 500 Supplemental funding includes $965K for vehicles and $1.5M for Boats. o Data Center Services is fully funded, which funds the DCS exceptional item of $25.1M with General Revenue and COVID Federal. o Seat Management HB 500 Supplemental funding includes $2.5M. o Texas Center for Infectious Disease Partially funded at $1.8M in General Revenue. Exceptional Item 2, Maintain Agency Infrastructure that Serves Texans and Communities o Regional Clinic Cost Increases and Space Planning Partially funded at $6.9M in General Revenue and 1 FTE. o Lab Building Maintenance of Critical Infrastructure Fully funded at $2.7M in General Revenue. o TCID Deferred Maintenance Fully funded at $6.6M in General Revenue. o Facility Cost Increase Partially funded at $1.8M in General Revenue. Exceptional Item 3, Expand Laboratory Capacity and Capability to Detect Risks to Health and Safety o New Laboratory Building HB 500 Supplemental funding includes $205M in capital authority with the ability to increase an additional $123.3M in capital authority as additional federal indirect is received. o Maintain Laboratory Staff Fully funded at $6.6M in 709 Medicaid Reimbursement funds and 38 FTEs.

Exceptional Items, continued Exceptional Item 4, Improve Child Mortality and Morbidity due to Congenital Syphilis o Partially funded at $8.4M in General Revenue and 23 FTEs. This was specially funded for the Nurse Strike Team and the Call Center. Exceptional Item 5, Ensure Access to Regional and Local Public Health Services o Not funded in the Conference Committee bill. Exceptional Item 6, Support Growth in Texas Industries and Career Entry o Texas Meat Industry Fully funded at $5.3M in General Revenue Related, 4 FTEs in FY26 and 10 FTEs in FY27. o The remaining of the exceptional item request was not funded in the Conference Committee bill. Exceptional Item 7, Reduce the Impacts of Tobacco-Related Cancers o Not funded in the Conference Committee bill Exceptional Item 8, Increase the Timeliness and Quality of Maternal and Child Health Data o Maternal Mortality and Morbidity HB 500 Supplemental bill funding includes $5.6M in General Revenue. The 7 FTEs were funded in the Intro bill. o Birth Defects Fully funded at $1.6M in General Revenue and 8 FTEs. Exceptional Item 9, Regulatory Automation System Replacement o Not funded in the Conference Committee bill.

Selected Bills

HB 2844 Mobile Food Vendors Authored by Rep. Landgraff/Sponsored by Sen. Kolkhorst Establishes licensing and regulation of mobile food vendors throughout the state Rules cannot limit the number of licenses issued, hours of operation, require vendors to enter into agreements with commercial establishments, or submit to health inspections other than DSHS No specific startup costs appropriated in SB 1/HB 500 Rules process must be completed by May 2026 with an effective date of July 2026

SB 1008 Local Food Service Permits Authored by Sen. Middleton/Sponsored by Rep. Harris Localities are prohibited from charging food service establishment a fee higher than what they would be charged in DSHS jurisdiction with slight flexibility for some larger counties and establishments with a poor history of compliance Localities must provide DSHS a fee schedule for posting on our website Restricts some sound regulation permits Additional permits to transport, deliver or serve food are restricted

SB 541 Cottage Food Productions Authored by Sen. Kolkhorst/Sponsored by Rep. Hull Cottage food operators now also include nonprofits (food must be produced at the home of the director or officer) Cottage food can be produced unless they are: Meat or seafood products; Ice or ice products (e.g. shaved ice, ice cream, popsicles, gelato); Low-acid canned goods; THC/CBD products; Raw milk Time and temperature-controlled products would require DSHS registration Localities cannot require licenses or permits of cottage food operators Raises the cap on an operation s annual gross income from $50K to $100K Allows an operation to sell to cottage food vendors at wholesale that could then be sold at farmers markets, food stands, retail stores, etc.

Large Implementation Bills SB 3 by Perry Hemp Total THC ban for hemp; allows only for CBD to 21+ adults DSHS will test products and maintain a list of acceptable ones that can be sold; DPS will conduct inspections and verifications SB 25 by Kolkhorst Make Texas Healthy Again Food manufacturers must label food if it contains certain banned ingredients from other countries such as Canada and the UK; DSHS would add this to the list of items to check for in inspections Also contains nutrition and metabolic health continuing education requirements for healthcare professionals Mandates recess/physical education for young children

Vaccine/Immunization Bills HB 1586 by Hull Vaccine Exemption Form DSHS will provide a downloadable exemption form online HB 4535 by McQueeny COVID-19 Vaccine Information Sheet Must receive written consent before administering COVID-19 vaccine Must include with the Vaccine Information Sheet: benefits/risks associated with the vaccine; expedited manner in which it was developed; whether long- term studies have been conducted; whether manufacturers are subject to civil liability for injuries, and reporting instructions for VAERS SB 269 by Perry Reports of Vaccine- or Drug-Related Adverse Events Requires physicians to report to VAERS or FDA s MedWatch any serious adverse effect suffered by a patient Only applies to vaccines or drugs that are experimental/investigational

SB 1188 Electronic Health Records (EHRs) Authored by Sen. Kolkhorst/Sponsored by Rep. Harris Requires healthcare entities to ensure that: Minor s health records are accessible to the minor s parents Personal health data is only accessible to those performing their appropriate duties Implement appropriate technical and administrative safeguards to protection EHRs Entities may not collect, store, or share info regarding an individual s credit score or voter registration status If healthcare practitioners use AI for diagnostic purposes, then they must review all records created with AI to ensure data is accurate

HB 18 Rural Health Stabilization and Innovation Act Authored by Rep. VanDeaver/Sponsored by Sen. Perry Creates the State Office of Rural Hospital Finance (housed under HHSC) Will be tasked with creating a needs and vulnerability index and a plan to help stabilize and support rural hospitals Establishes grant programs such as the Rural Hospital Support Grant, the Innovation Grant Program, and the Emergency Hardship Grant Program Particular focuses include rural mental health and tele-pediatrics