|(a) A license holder shall:
(1) enter into a service agreement with a client, as
defined in §121.10, when behavior analysis services are to be
(A) A behavior analyst shall describe the services
to be delivered in a service agreement that may include the following
activities: consultation, assessment, training, treatment design,
treatment implementation, and treatment evaluation.
(B) A behavior analyst shall create a treatment plan
when the service agreement provides for delivering treatment to an
(C) A treatment plan is not required if a license holder
will not deliver treatment to an individual.
(2) include in the service agreement or otherwise document
and disclose to a client, as appropriate:
(A) the client's consent to treatment that is transitional
or provisional or for which its effectiveness has not yet been established,
or effectiveness has not yet been established for the method, manner,
or mode of treatment for which consent is obtained;
(B) conflicts of interest or multiple relationships
that a license holder is aware of or becomes aware of, as defined
(C) a description of how a conflict of interest or
multiple relationship will be addressed if one is discovered or disclosed;
(D) the acknowledgment of known conflicts of interest
or multiple relationships and agreement to begin or to continue behavior
analysis services despite them; and
(E) a reasoned justification for beginning or continuing
to provide behavior analysis services if conflicts of interest or
multiple relationships are acknowledged;
(3) re-evaluate treatment progress as needed and at
least annually, and document the evaluation; and
(4) comply with all applicable requirements of the
license holder's certifying entity, including the BACB Professional
and Ethical Compliance Code for Behavior Analysts, when entering into
service agreements and providing behavior analysis services.
(b) If any requirement of a license holder's certifying
entity differs in stringency from a requirement of the Act or the
commission rules, the more stringent provision shall apply.
(c) If any requirement of a license holder's certifying
entity conflicts with a requirement of the commission rules such that
the license holder cannot reasonably comply with both requirements,
the license holder shall comply with the requirement of the certifying
(d) Professional Services Practice Responsibilities:
(1) Except to the extent it imposes additional or more
stringent requirements, this subsection does not affect the applicability
of any other requirement or provision of law to which a person is
subject under the Act, this chapter, or other law, or by the person's
certifying entity, when the person is functioning as a provider of
(2) The requirements of this section apply to the use
of telehealth by behavior analysts and assistant behavior analysts
licensed under this chapter.
(3) A license holder shall provide the same quality
of services via telehealth as is provided during in-person sessions.
A telehealth provider shall maintain a focus on evidence-based practice
and identify appropriate meaningful outcomes for a client. When an
established telehealth procedure is not available, a license holder
shall notify a client or multi-disciplinary team, as appropriate,
that the effectiveness of the procedure has not yet been established
for the method, manner, or mode of treatment.
(4) A telehealth provider shall notify a client or
multi-disciplinary team, as appropriate, of the conditions of telehealth
services, including, but not limited to, the right to refuse telehealth
services, options for service delivery, differences between in-person
and remote service delivery methods, and instructions for filing and
(A) A telehealth provider shall obtain client consent
before services may be provided through telehealth.
(B) A provider shall consider relevant factors including
the client's behavioral, physical, and cognitive abilities in determining
the appropriateness of providing services via telehealth.
(C) If a client previously consented to in-person services,
a telehealth provider shall obtain updated consent to include telehealth
(5) Telehealth providers shall not provide services
by correspondence only, e.g., mail, email, or faxes, although these
may be used as adjuncts to telehealth.
(6) The initial contact between a license holder and
a client may be at the same physical location or through telehealth,
as deemed appropriate by the license holder.
(7) Telehealth providers shall comply with all laws,
rules, and certifying entity requirements governing the maintenance
of client records, including client confidentiality requirements,
regardless of the state where the records of any client within this
state are maintained.
(8) A telehealth provider shall be sensitive to cultural
and linguistic variables that affect the identification, assessment,
treatment, and management of a client when providing services through
(9) Supervision undertaken through telehealth must
meet the standards of the certifying entity.
(10) Subject to the requirements and limitations of
this section, a telehealth provider may utilize a facilitator at a
client site to assist the provider in rendering telehealth services.
(11) A telehealth provider, before allowing a facilitator
to assist a provider in rendering telehealth services, shall ascertain
a facilitator's qualifications, training, and competence, as appropriate
and reasonable, for each task a provider directs a facilitator to
perform, and in the methodology and equipment a facilitator is to
(12) A facilitator may perform at a client site only
the following tasks:
(A) a task for which a facilitator holds and acts in
accordance with any relevant license, permit, or authorization required
or exemption available under the Texas Occupations Code to perform
the task; and
(B) those physical, administrative, and other tasks
for which a telehealth provider determines a facilitator is competent
to perform in connection with the rendering of behavior analysis services
for which no license, permit, or authorization under the Texas Occupations
Code is required or to which an exemption applies.
(13) A telehealth provider shall be able to see and
hear a client and a facilitator, if used, via telecommunications technology
in synchronous, real-time interactions, even when receiving or sending
data and other telecommunication transmissions, when providing telehealth
(14) A telehealth provider shall not render telehealth
services to a client if the presence of a facilitator is required
for safe and effective service to a client and no qualified facilitator
(15) A telehealth provider shall document the provider's
telehealth services to the same standard as in-person services.