TITLE 26. HEALTH AND HUMAN SERVICES

PART 1. HEALTH AND HUMAN SERVICES COMMISSION

CHAPTER 749. MINIMUM STANDARDS FOR CHILD-PLACING AGENCIES

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §§749.801, 749.811, 749.813, 749.831, 749.833, 749.861, 749.863 - 749.865, 749.867 - 749.869, 749.881 - 749.883, 749.885, 749.887, 749.889, 749.911, 749.913, 749.915, 749.930, 749.931 - 749.933, 749.935, 749.937, 749.939, 749.941, 749.943 - 749.945, 749.947, 749.949, 749.1001, 749.1003, 749.1005, 749.1007, 749.1009, 749.1011, 749.1013, 749.1015, 749.1017, 749.1019, 749.1021, 749.1101, 749.1103, 749.1105, 749.1107, 749.1109, 749.1111, 749.1113, 749.1115, 749.1131, 749.1133, 749.1135, 749.1137, 749.1151, 749.1153, 749.1155, 749.1181, 749.1183, 749.1185, 749.1187, 749.1189, 749.1251, 749.1253, 749.1255, 749.1281, 749.1291, 749.1301, 749.1305, 749.1307, 749.1309, 749.1311 - 749.1313, 749.1315, 749.1317, 749.1319, 749.1321, 749.1323, 749.1331, 749.1333, 749.1335 - 749.1337, 749.1339, 749.1361, 749.1363, 749.1365, 749.1367, 749.1369, 749.1371, 749.1373, 749.1377, 749.1401, 749.1403, 749.1405, 749.1409, 749.1411, 749.1413, 749.1415, 749.1417, 749.1421, 749.1423, 749.1425, 749.1427, 749.1429, 749.1431, 749.1433, 749.1435, 749.1437, 749.1461, 749.1463, 749.1469, 749.1501, 749.1503, 749.1521, 749.1541, 749.1543, 749.1545, 749.1561, 749.1563, 749.1565, 749.1581, 749.1583, 749.1603, 749.1605, 749.1607, 749.1609, 749.1611, 749.1641, 749.1643, 749.1645, 749.1647, 749.1671, 749.1673, 749.1675, 749.1801, 749.1803, 749.1805, 749.1807, 749.1809, 749.1811, 749.1813, 749.1815, 749.1817, 749.1819, 749.1821, 749.1841, 749.1861, 749.1863, 749.1865, 749.1891, 749.1893, 749.1895, 749.1921, 749.1923, 749.1925, 749.1927, 749.1951, 749.1953, 749.1955, 749.1957, 749.1959, 749.1961, 749.2001, 749.2051, 749.2053, 749.2055, 749.2059, 749.2061, 749.2063, 749.2101, 749.2103, 749.2105, 749.2107, 749.2151, 749.2153, 749.2201, 749.2203, 749.2205, 749.2231, 749.2233, 749.2281, 749.2283, 749.2301, 749.2303, 749.2305, 749.2307, 749.2331, 749.2333, 749.2335, 749.2337, 749.2339, 749.2381, 749.2383, 749.2401, 749.2403, 749.2405, 749.2407, 749.2445, 749.2447, 749.2449, 749.2451, 749.2453, 749.2470, 749.2473, 749.2475, 749.2477, 749.2479, 749.2481, 749.2483, 749.2485, 749.2487 - 749.2489, 749.2491, 749.2493, 749.2495, 749.2497, 749.2520, 749.2521, 749.2523, 749.2525 - 749.2527, 749.2529, 749.2531, 749.2533, 749.2535, 749.2537, 749.2539, 749.2550, 749.2551, 749.2555, 749.2557, 749.2591, 749.2593, 749.2595, 749.2597, 749.2599, 749.2601, 749.2603, 749.2605, 749.2607, 749.2621, 749.2623, 749.2625, 749.2627, 749.2629, 749.2631, 749.2633, 749.2635, 749.2651, 749.2653, 749.2655, 749.2801, 749.2803, 749.2805, 749.2807, 749.2809, 749.2811, 749.2813 - 749.2815, 749.2817, 749.2819, 749.2821, 749.2823, 749.2825, 749.2901 - 749.2905, 749.2907 - 749.2909, 749.2911, 749.2913, 749.2915, 749.2917, 749.2931, 749.2961, 749.2963, 749.2965, 749.2967, 749.3021, 749.3023, 749.3025, 749.3027, 749.3029, 749.3031, 749.3033, 749.3035, 749.3037, 749.3039, 749.3041, 749.3043, 749.3061, 749.3063, 749.3065, 749.3067, 749.3069, 749.3071, 749.3073, 749.3075, 749.3077, 749.3079, 749.3081, 749.3101, 749.3103, 749.3105, 749.3107, 749.3109, 749.3111, 749.3131, 749.3133, 749.3135, 749.3137, 749.3139, 749.3141, 749.3143, 749.3145, 749.3147, 749.3149, and 749.3151; and new §§749.801, 749.803, 749.805, 749.807, 749.821, 749.823, 749.825, 749.831, 749.901, 749.903, 749.905, 749.921, 749.923, 749.925, 749.927, 749.929, 749.931, 749.933, 749.935, 749.937, 749.951, 749.953, 749.955, 749.957, 749.959, 749.973, 749.975, 749.977, 749.1001, 749.1003, 749.1005, 749.1007, 749.1009, 749.1011, 749.1013, 749.1015, 749.1017, 749.1019, 749.1031, 749.1033, 749.1035, 749.1037, 749.1051, 749.1053, 749.1061, 749.1063, 749.1065, 749.1101, 749.1103, 749.1105, 749.1107, 749.1109, 749.1201, 749.1203, 749.1205, 749.1207, 749.1209, 749.1211, 749.1213, 749.1215, 749.1217, 749.1231, 749.1233, 749.1235, 749.1237, 749.1251, 749.1253, 749.1301, 749.1303, 749.1305, 749.1307, 749.1401, 749.1403, 749.1405, 749.1407, 749.1409, 749.1411, 749.1413, 749.1415, 749.1417, 749.1419, 749.1421, 749.1423, 749.1501, 749.1503, 749.1505, 749.1601, 749.1603, 749.1605, 749.1607, 749.1621, 749.1623, 749.1625, 749.1631, 749.1633, and 749.1635.

BACKGROUND AND PURPOSE

The purpose of this proposal is to (1) comply with Texas Human Resources Code (HRC) §42.042(b); (2) implement an HHSC initiative for reasonable regulatory reform stemming from HRC §42.027, created by Senate Bill (SB) 593, 88th Legislature, Regular Session, 2023; and (3) implement House Bill (HB) 1403, 89th Legislature, Regular Session, 2025.

HRC §42.042(b) requires HHSC Child Care Regulation (CCR) to conduct a comprehensive review of minimum standards at least once every six years. SB 593 requires HHSC to contract with an independent entity to assess HHSC rules, minimum standards, Texas Department of Family and Protective Services contract requirements, and standards or oversight requirement prescribed by law.

The purpose of the comprehensive review is to (1) identify any minimum standards that need clarification and to make amendments; (2) identify any minimum standards that may not have the intended outcome and amend or repeal those identified; and (3) ensure that minimum standards are consistent with current research, best practices, and other guidelines. This is also the purpose of reasonable regulatory reform; however, reasonable regulatory reform also identified opportunities to eliminate requirements that were outdated, redundant, or unnecessarily burdensome to providers and HHSC staff, while streamlining and improving requirements that are necessary to protect the health, safety, and well-being of children in foster care.

The purpose of HB 1403 is to ensure the confidentiality of foster homes related to firearms. HB 1403 prohibits HHSC or a child-placing agency (CPA) from requiring a foster home to (1) disclose the specific types of firearms that are present in the home; or (2) notify the CPA if there is any change in the types of firearms present in the home.

Additionally, the rules have been written in plain language to improve understanding and effectiveness of the rules.

SECTION-BY-SECTION SUMMARY

The proposed repeal of Subchapter F, Training and Professional Development, consisting of §§749.801, 749.811, 749.813, 749.831, 749.833, 749.861, 749.863 - 749.865, 749.867 - 749.869, 749.881 - 749.883, 749.885, 749.887, 749.889, 749.911, 749.913, 749.915, 749.930, 749.931 - 749.933, 749.935, 749.937, 749.939, 749.941, 749.943, 749.944, 749.945, 749.947, and 749.949, deletes the subchapter and the rules it contains as the requirements have been consolidated into a new Subchapter F, Training Requirements.

Proposed new Subchapter F, Training Requirements, establishes training requirements for caregivers and employees.

Proposed new Division 1, Caregiver Training Requirements, in Subchapter F, establishes the training requirements that apply to caregivers.

Proposed new §749.801, Caregiver Pre-Verification Requirements, establishes the training requirements each caregiver must complete before a CPA can verify the foster home.

Proposed new §749.803, General Caregiver Training Requirements, establishes the general training requirements that at least one foster parent must complete before the CPA places a child in care in the foster home. The rule also establishes the training requirements and timeframe for completion for other caregivers in the foster home and allows the CPA to determine if emergency behavior intervention training is necessary based on the ages of the children in care of the home and the types of services provided.

Proposed new §749.805, Pediatric First Aid and Pediatric Cardiopulmonary Resuscitation (CPR) Requirements, requires one foster parent to be certified in pediatric first aid and pediatric CPR before the home's verification. The rule requires other caregivers to be certified within 90 days after the CPA issues the home's verification. The rule clarifies that the training must (1) include training related to rescue breathing and choking, and (2) adhere to guidelines for CPR established by the American Heart Association.

Proposed new §749.807, Additional Caregiver Training Requirements, establishes the additional training requirements for caregivers. The rule requires the CPA to evaluate the foster home for concerns at least once every year. If the CPA identifies concerns, the rule requires the CPA to provide all caregivers in the home with additional training appropriate to the identified concerns. The rule also requires the CPA to provide at least one hour of annual training to each foster parent who provides care to a child in care receiving treatment services.

Proposed new Division 2, Employee Training Requirements, in Subchapter F, establishes the training requirements that apply to CPA employees.

Proposed new §749.821, Employee Orientation Requirements, establishes orientation requirements for employees. The rule requires each employee to have orientation before beginning job duties that includes (1) an overview of the minimum standards in Chapter 749; (2) the CPA's structure, policies, and services; and (3) the needs and characteristics of the children the CPA serves.

Proposed new §749.823, New Employee Training Requirements, establishes the general new employee training requirements and timeframes for completion. The rule requires that within 30 days after the employee's start date, CPA administrators, treatment directors, child placement staff, child placement management staff, and full-time professional service providers complete training in normalcy, trauma informed care, preventing the spread of communicable diseases, and emergency behavior intervention. The rule clarifies that there are certain exemptions for employees exclusively assigned responsibilities related to adoption services and employees exclusively assigned responsibilities related to the care of children in care receiving treatment services for primary medical needs. The rule requires employees defined as caregivers to obtain pediatric first aid and CPR training.

Proposed new §749.825, Employee Annual Training Requirements, establishes the annual employee training requirements. The rule requires child placement staff, child placement management staff, executive director, treatment directors, and CPA administrators to complete at least 15 hours of annual training. The rule specifies that at least one hour of the 15 required hours must cover prevention, recognition, and reporting of child abuse, neglect, and exploitation. The rule allows for a CPA to establish the method the CPA will use to track annual training.

Proposed new Division 3, Employee and Caregiver Training Documentation Requirements, in Subchapter F, contains requirements for documenting caregiver and employee training.

Proposed new §749.831, Employee and Caregiver Documentation of Required Trainings, establishes documentation requirements for caregiver and employee trainings. The rule requires the CPA to document if a training requirement is waived and how the CPA determined waiving the requirement was appropriate. It also requires that training certificates for pediatric first aid and pediatric CPR have an expiration date and be renewed before the expiration date.

The proposed repeal of Subchapter G, Children's Rights, consisting of 749.1001, 749.1003, 749.1005, 749.1007, 749.1009, 749.1011, 749.1013, 749.1015, 749.1017, 749.1019, and 749.1021, deletes the subchapter and the rules it contains as the requirements have been consolidated into new Subchapter L, Child Rights.

Proposed new Subchapter G, Foster Home Screenings and Verifications, establishes requirements for screening and verifying a foster home.

Proposed new Division 1, Foster Home Screenings, in Subchapter G, contains rules relating to the requirements for foster home screenings.

Proposed new §749.901, Foster Home Screenings, describes the specific categories of information the CPA must obtain, discuss, assess, and document through interviews with each prospective foster parent, joint interviews with prospective foster parents, and reference checks required in proposed new §749.903. The rule also requires a CPA to report any information obtained about domestic violence to CCR.

Proposed new §749.903, Required Interviews and Reference Checks, establishes the required interviews and reference checks that must be completed when a CPA conducts a home screening. The rule allows CPAs to skip certain interviews after showing they attempted to contact the individual at least three separate times.

Proposed new §749.905, Home Screening Documentation Requirements, establishes the documentation requirements for a home screening.

Proposed new Division 2, Foster Home Verification, in Subchapter G, establishes the requirements to verify a foster home.

Proposed new §749.921, General Requirements, establishes the general requirements for a foster home verification. The rule (1) requires foster parents to be at least 18 years old; (2) establishes circumstances when a CPA can verify an individual spouse as a foster parent; and (3) prohibits a foster home from being verified by more than one CPA at a time for foster care services.

Proposed new §749.923, Verifying a Foster Home, establishes steps the CPA takes to complete a foster home verification, including documentation requirements, interviews, and inspections. The rule also requires the CPA to obtain approval from the child placement management staff for the home screening and verification.

Proposed new §749.925, Temporary Foster Home Verifications, establishes requirements for a CPA to issue a temporary foster home verification.

Proposed new §749.927, Provisional Verifications, establishes requirements for a CPA to issue a provisional foster home verification.

Proposed new §749.929, Previously Verified Foster Homes, establishes requirements for working with foster homes that were previously verified by or transferring from another CPA.

Proposed new §749.931, Releasing Information About a Previously Verified Foster Home, establishes requirements for releasing information about a previously verified foster home. The rule requires a CPA to release background information about current and previous foster homes to other CPAs and independent contractors who are hired or required by the court.

Proposed new §749.933, Foster Home Verification Changes, establishes requirements for changing the verification status of a foster home. The rule (1) describes changes a CPA must inform CCR about within two business days; (2) requires that child placement management staff ensure that any additional services offered by a foster home do not create a conflict of care with children currently in the home; and (3) requires background checks and impact analysis when a foster home adds a new, unrelated household member.

Proposed new §749.935, Foster Homes that Provide Day Care, establishes requirements for foster homes that also provide day care.

Proposed new §749.937, Transferring or Closing a Foster Home, establishes the criteria for a transfer or closing summary for a foster home, including details for the summary and timeframes for completion.

Proposed new Division 3, Capacity and Supervision, in Subchapter G, establishes capacity limits for a foster home and supervision requirements.

Proposed new §749.951, Capacity and Child/Caregiver Ratio, establishes capacity limits for a foster home and the criteria a CPA must assess and document when determining a foster home's capacity.

Proposed new §749.953, Expanding Capacity of a Foster Home, establishes requirements for a CPA to approve a capacity of seven or eight children for a foster home.

Proposed new §749.955, Supervision, establishes supervision requirements at a foster home. The rule outlines the factors the CPA must consider when determining supervision needs for each child in care. The rule also addresses the caregiver's responsibilities and the information a caregiver must have when a child in care participates in an unsupervised childhood activity.

Proposed new §749.957, Supervision with Video Cameras, establishes the circumstances under which video cameras may be used for supervision.

Proposed new §749.959, Transitional Living Program Supervision, establishes supervision requirements for a transitional living program.

Proposed new Division 4, Babysitting, Overnight Care, and Respite Care, in Subchapter G, establishes requirements for babysitters, overnight care, and respite care providers.

Proposed new §749.973, Children in Care as Babysitters, establishes requirements for when a child, including a child in care, may act as a babysitter.

Proposed new §749.975, Respite Child-Care Services, establishes requirements for respite care services.

Proposed §749.977, Information Sharing with Babysitter, Overnight Care Provider, or Respite Care Providers, establishes the information that a CPA must share with a babysitter or provider.

The proposed repeal of Subchapter H, Foster Care Services: Admission and Placement, consisting of 749.1101, 749.1103, 749.1105, 749.1107, 749.1109, 749.1111, 749.1113, 749.1115, 749.1131, 749.1133, 749.1135, 749.1137, 749.1151, 749.1153, 749.1155, 749.1181, 749.1183, 749.1185, 749.1187, 749.1189, 749.1251, 749.1253, 749.1255, 749.1281, and 749.1291, deletes the subchapter and the rules it contains as the requirements have been consolidated into new Subchapter J, Admission and Placement.

Proposed new Subchapter H, Health and Safety Requirements, contains rules relating to health and safety, environment, space, and equipment in foster homes.

Proposed new Division 1, Physical Environment Safety, in Subchapter H, establishes requirements for the foster home's physical environment, fire and health inspections, emergency plans, animals, tobacco use, nutrition, and transportation.

Proposed new §749.1001, Physical Environment of a Foster Home, establishes requirements related to the safety of indoor and outdoor space and equipment. The rule requires the home to ensure that indoor and outdoor space and equipment does not pose a safety risk to a child in care. The rule also includes supervision requirements to prevent a child in care from having access to space or equipment that poses a safety risk to a child in care.

Proposed new §749.1003, Health Inspections, establishes requirements for health inspections or evaluations at a foster home. The rule describes who must conduct the inspection or evaluation and requires a home to correct deficiencies and comply with any conditions or restrictions.

Proposed new §749.1005, Fire Inspections, establishes requirements for fire inspections or evaluations at a foster home. The rule describes who must conduct the inspection or evaluation and requires a home to correct deficiencies and comply with any conditions or restrictions.

Proposed new §749.1007, Fire Safety, establishes fire safety requirements. The rule includes the places in a foster home where there must be a working smoke detector; a requirement for the home to have at least one non-expired and operational fire extinguisher that is accessible in an emergency; and that the home must ensure that exits to the home are not blocked.

Proposed new §749.1009, Emergency Plans, establishes requirements for a written plan that a foster home must have for handling potential disasters and emergencies, including fire and severe weather. The rule requires the CPA that verified the home to annually review and evaluate the plan with all caregivers and children in the care of the home.

Proposed new §749.1011, Animals, requires that any animals at a foster home do not pose a health or safety threat to children in care and that all pets are vaccinated according to state law against diseases that can transmit to humans.

Proposed new §749.1013, Tobacco and E-Cigarette Use, prohibits household members and visitors from smoking tobacco products, e-cigarettes, or vaporizers in the presence of children in care and inside the foster home or motor vehicle.

Proposed new §749.1015, Nutrition and Food Safety, establishes requirements for food and food safety at a foster home, including that (1) caregivers provide children in care with drinking water and food that is served in a safe and sanitary manner; and (2) all food items are stored in a manner that protects them from contamination, spoiling, insects, and rodents.

Proposed new §749.1017, Transportation, establishes requirements for transporting a child in care. The rule requires caregivers to (1) secure safe and reliable transportation; (2) make special provisions for transporting children in care who are non-ambulatory or non-mobile; and (3) secure each child in care in a safety seat or safety belt appropriate to their age, height, and weight.

Proposed new §749.1019, Documentation of Health and Safety Requirements, establishes health and safety requirements a CPA must document in a foster home's record.

Proposed new Division 2, Weapons, Firearms, Explosive Materials, and Projectiles, in Subchapter H, contains rules related to the use and presence of weapons, firearms, explosive materials, and projectiles.

Proposed new §749.1031, Weapons, Firearms, Explosive Materials, and Projectiles in a Foster Home, establishes requirements related to weapons, firearms, explosive materials, and projectiles in a foster home. The rule (1) requires each CPA to have a policy identifying specific precautions to ensure a child in care does not have unsupervised access to these items; and (2) requires the CPA to determine whether it is appropriate for a specific child in care to use a weapon, firearm, explosive material, or projectile or to use a toy that explodes or shoots.

Proposed new §749.1033, Storage of Weapons, Firearms, Explosive Materials, or Projectiles in a Foster Home, establishes factors the CPA must consider when determining if a weapon, firearm, explosive material, or projectile is stored adequately in a foster home. The rule specifies that a CPA may not require a foster home to disclose the specific types of firearms that are stored or otherwise present in the foster home, nor may a CPA require a foster home to notify the CPA if there is any change in the types of firearms present in the home. The rule exempts firearms that are inoperable and solely ornamental from storage requirements.

Proposed new §749.1035, Determining if Weapons, Firearms, Explosive Materials, or Projectiles are Present in a Foster Home, establishes how a CPA determines if weapons, firearms, explosive materials, and projectiles are present at a foster home. The rule requires the CPA to assess this information during the home screening and document (1) whether weapons, firearms, explosive materials, or projectiles are present in the home; and (2) specific precautions the caregiver must take to ensure that the children in care do not have unsupervised access. The rule specifies that a CPA may not require a foster home to disclose the specific types of firearms that are stored or otherwise present in the home or to notify the CPA if there is any change in the types of firearms present in the home. The rule further requires the CPA to discuss these items with the foster home during the annual evaluation.

Proposed new §749.1037, Transporting a Child in Care in a Vehicle Where Firearms, Weapons, Explosive Materials, or Projectiles are Present, establishes requirements for transporting a child in care in a vehicle where firearms, explosive materials, or projectiles are present. Due to the statutory requirements in HRC §42.042(e-2), the rule addresses requirements related to transporting a child in care in a vehicle where a handgun is present separately from the requirements related to transporting a child in care in a vehicle where another type of firearm or an explosive material or projectile is present.

Proposed new Division 3, Sleeping Space and Bathroom Requirements, in Subchapter H, contains rules relating to space and bathrooms.

Proposed new §749.1051, Indoor Space: Sleeping Spaces and Sleeping Surfaces, establishes requirements related to sleeping spaces and surfaces used by a child in care, as well as what CPMS must determine and document before approving a child in care to share a sleeping space or surface with another individual.

Proposed new §749.1053, Indoor Space: Bathrooms, describes bathroom requirements for a foster home.

Proposed new Division 4, Pools and Water Activities, in Subchapter H, contains rules relating to swimming pools and water activities.

Proposed new §749.1061, Water Safety: Pools, Hot Tubs, and Bodies of Water, establishes general safety rules for swimming pools, hot tubs, and bodies of water, including barriers and locks.

Proposed new §749.1063, Swimming Supervision, establishes supervision requirements for swimming activities.

Proposed new §749.1065, Swimming Ratios, establishes child-to-caregiver ratios when children in care are swimming.

The proposed repeal of Subchapter I, Foster Care Services: Service Planning, Discharge, consisting of 749.1301, 749.1305, 749.1307, 749.1309, 749.1311 - 749.1313, 749.1315, 749.1317, 749.1319, 749.1321, 749.1323, 749.1331, 749.1333, 749.1335 - 749.1337, 749.1339, 749.1361, 749.1363, 749.1365, 749.1367, 749.1369, 749.1371, 749.1373, and 749.1377, deletes the subchapter and the rules it contains as the requirements have been consolidated into new Subchapter K, Service Planning and Discharge.

Proposed new Subchapter I, Foster Home Management and Evaluation, establishes requirements for ongoing management and evaluation of foster homes.

Proposed new §749.1101, Foster Home Verification Change Management, requires a new or temporary verification to be issued to a foster home that experiences a change that invalidates the home's verification. The rule clarifies what changes automatically invalidate a home's verification.

Proposed new §749.1103, Foster Home Compliance Evaluation, establishes what a CPA evaluates to assess a foster home's ongoing compliance. The rule establishes the steps a CPA must take if a deficiency is noted during an evaluation.

Proposed new §749.1105, Foster Home Supervisory Visits, establishes the requirements for supervisory visits to a foster home, including how often the supervisory visits must be completed, who must be present, and what must be evaluated.

Proposed new §749.1107, Inactive Foster Homes, establishes requirements for foster homes to be placed on inactive status and requirements to become active again.

Proposed new §749.1109, Ongoing Monitoring Documentation Requirements, establishes documentation requirements for the ongoing monitoring of a foster home. The rule specifies documentation requirements for when a CPA is evaluating the home for compliance or completing a supervisory visit and when a home is placed on or removed from inactive status.

The proposed repeal of Subchapter J, Foster Care Services: Medical and Dental, consisting of 749.1401, 749.1403, 749.1405, 749.1409, 749.1411, 749.1413, 749.1415, 749.1417, 749.1421, 749.1423, 749.1425, 749.1427, 749.1429, 749.1431, 749.1433, 749.1435, 749.1437, 749.1461, 749.1463, 749.1469, 749.1501, 749.1503, 749.1521, 749.1541, 749.1543, 749.1545, 749.1561, 749.1563, 749.1565, 749.1581, 749.1583, 749.1603, 749.1605, 749.1607, 749.1609, 749.1611, 749.1641, 749.1643, 749.1645, 749.1647, 749.1671, 749.1673, and 749.1675, deletes the subchapter and the rules it contains as the requirements have been consolidated into new Subchapter M, Medical and Dental Requirements.

Proposed new Subchapter J, Admission and Placement, establishes requirements for admission and placement.

Proposed new §749.1201, Admission Criteria, establishes that a CPA may admit a child or young adult into care who meets the CPA's admission policy.

Proposed new §749.1203, Initial Requirements at the Time of Admission or Verification, establishes the initial admission information that a CPA must attempt to obtain when admitting a child into the care of a foster home. It requires the CPA to provide the prospective caregivers with the initial admission information within 24 hours after the date of admission.

Proposed new §749.1205, Admission Assessment, establishes the information that a CPA must obtain when completing the admission assessment. The rule requires the admission assessment to be complete within 15 days after the date of a child's admission and requires the admission assessment to be provided to the caregivers and professional service providers within five days after the assessment is completed. The rule also establishes additional admission assessment criteria for children in care who receive treatment services for primary medical needs.

Proposed new §749.1207, Admission Orientation Requirements, requires the CPA to provide orientation to each child five years of age or older in care within seven days of admission. The rule requires orientation to include information about the CPA's child-care policies.

Proposed new §749.1209, Placement Agreement, establishes requirements for the placement agreement. The rule requires the placement agreement to define the CPA's roles and responsibilities and authorizes the CPA to obtain or provide services for the child in care.

Proposed new §749.1211, Pre-Placement Requirements, establishes requirements the CPA must complete with the child in care before placing the child in a foster home: (1) discuss the reason for the placement with the child in care; (2) visit the foster home at least once if the child in care is over six months old; (3) observe the interactions between the child in care and household members; and (4) meet privately and separately with the child in care and foster parents to discuss placement after the visit.

Proposed new §749.1213, Post-Placement Contacts, requires the CPA staff to have monthly in-person visits with the child in care. The rule requires that this visit must occur in the foster home every other month and establishes what must take place during the visit.

Proposed new §749.1215, Ongoing Placement of Young Adults, establishes requirements for young adults to remain in care at a foster home.

Proposed new §749.1217, Admission and Placement Information Documentation, establishes documentation requirements for admission and placement of children into the care of a foster home.

Proposed new Subchapter K, Service Planning and Discharge, establishes requirements related to service planning and discharge.

Proposed new Division 1, Service Planning, establishes requirements related to service planning.

Proposed new §749.1231, General Service Plan Requirements, establishes the general requirements for a service plan. The rule allows the CPA to use the child's most recent service plan developed by the agency that referred the child for placement, or for the CPA to complete a service plan and subsequent reviews.

Proposed new §749.1233, Initial Service Plan Requirements, establishes requirements for the service planning team to complete an initial service plan, including the specific needs that must be identified and addressed. The rule has additional requirements for children in care that receive treatment services. The rule requires the initial service plan to be completed within 60 days after the child is admitted into care and reviewed at least every 180 days after the date of the last service plan.

Proposed new §749.1235, Service Plan Requirements for Children in Care Receiving Treatment Services, requires the CPA to obtain a psychosocial assessment, or equivalent assessment or evaluation, for each child in care receiving treatment services for emotional disorders, autism spectrum disorders, or intellectual disabilities. The rule establishes a timeframe for the assessment to be completed.

Proposed new §749.1237, Service Plan Documentation Requirements, establishes the documentation requirements for the service plan and psychosocial assessment.

Proposed new Division 2, Discharge and Transfer Planning, in Subchapter K, establishes requirements related to discharge and transfer for a child in care.

Proposed new §749.1251, Discharge and Transfer Requirements, establishes requirements for discharging or transferring a child in care. The rule establishes who a child in care can be discharged to and the information that must be shared with that individual and outlines the CPA's responsibilities for discharging or transferring a child in care, including the requirements for a discharge or transfer summary.

Proposed new §749.1253, Discharge and Transfer Documentation Requirements, establishes what the CPA must document when completing a discharge or transfer.

The proposed repeal of Subchapter K, Foster Care Services: Daily Care, Problem Management, deletes the subchapter and the rules it contains as the requirements have been consolidated into proposed new Subchapter M, Daily Care, Education, and Discipline.

Proposed new Subchapter L, Child Rights, consisting of §§749.1301, 749.1303, 749.1305, and 749.1307, establishes the rights guaranteed to children in care and the CPA's responsibilities for ensuring the rights of a child in care are not violated.

Proposed new §749.1301, Child-Placing Agency Responsibilities Related to Child Rights, establishes the CPA's responsibilities related to child rights for a child in care. The rule requires the CPA to (1) protect rights of a child in care; (2) remove a child in care from situations where abuse, neglect, or exploitation exists, (3) review the child's rights with the child in care and the child's parent; and (4) ensure child's rights are written in plain language that can be understood by the individual they are reviewed with.

Proposed new §749.1303, Child Rights, establishes the child's rights that a CPA must adhere to: (1) safety and care; (2) family contacts; (3) living a normal life; (4) discipline; (5) plans for the child while in care of the CPA; (6) medical care and records; and (7) making complaints.

Proposed new §749.1305, Conducting Searches for Items that Endanger a Child's Safety, establishes requirements for an employee or caregiver conducting searches for items that endanger the safety of a child in care. The rule specifies when a search can be conducted, who can conduct the search, and prohibits body cavity searches.

Proposed new §749.1307, Child Rights Documentation Requirements, establishes documentation requirements for review of a child's rights, plans for contact between a child in care and the family of the child in care, and the results of specific searches involving a child in care.

The proposed repeal of Subchapter L, Foster Care Services: Emergency Behavior Intervention, consisting of 749.2001, 749.2051, 749.2053, 749.2055, 749.2059, 749.2061, 749.2063, 749.2101, 749.2103, 749.2105, 749.2107, 749.2151, 749.2153, 749.2201, 749.2203, 749.2205, 749.2231, 749.2233, 749.2281, 749.2283, 749.2301, 749.2303, 749.2305, 749.2307, 749.2331, 749.2333, 749.2335, 749.2337, 749.2339, 749.2381, and 749.2383, deletes the subchapter and the rules it contains as the requirements have been consolidated into proposed new Subchapter O, Emergency Behavior Intervention Requirements.

Proposed new subchapter M, Daily Care, Education, and Discipline, contains rules relating to the daily care, education, and discipline of children in care.

Proposed new §749.1401, Infants: Basic Care and Supervision, establishes basic care and supervision requirements for infants in a foster home. The rule establishes (1) that infants must receive individual and prompt attention; (2) environmental requirements, including (A) keeping the area free of harmful objects, including diaper changing items, and (B) ensuring electrical outlets are inaccessible; and (3) that an infant may never be left unsupervised. The rule defines infant supervision requirements and what is considered supervision for a sleeping infant and an awake infant.

Proposed new §749.1403, Infants: Cribs, establishes crib requirements for infants. The rule (1) requires a foster home to have an individual crib that meets certain requirements for an infant; (2) clarifies when the home may use a portable or mesh-side crib; (3) prohibits (A) using a stackable crib for an infant, and (B) leaving an infant in a portable crib or mesh-side crib with a side folded down; (4) clarifies that special items may be used to assist with safe sleep in a crib used by an infant with primary medical needs with the written recommendation from a health care professional; and (5) requires the CPA to notify the parent of each child in care of each foster home verified by the CPA if specific rules in the rule are cited as deficient.

Proposed new §749.1405, Infants: Safe Sleep Requirements, establishes safe sleep requirements for infants. The rule requires caregivers to (1) place an infant who is unable to roll over without help on the infant's back to sleep unless a health care professional orders otherwise; (2) ensure the infant's head, face, and crib are not covered by any item; (3) ensure the infant does not (A) co-sleep with an individual, or (B) sleep in a restrictive device, such as a car seat, swing, or highchair; and (4) ensure swaddling is only used for infants who cannot roll over without help. The rule requires the CPA to notify the parent of each child in care of each foster home verified by the CPA if specific rules in the rule are cited as deficient.

Proposed new §749.1407, Infants: Equipment Safety, establishes equipment safety requirements for infants.

Proposed new §749.1409, Infants: Feeding Requirements, establishes feeding requirements for infants. The rule requires caregivers to (1) feed an infant based on the recommendations of the infant's health-care professional; (2) hold infants birth through six months of age or unable to sit unassisted while feeding; (3) never prop a bottle with anything other than the infant's or adult's hands; and (4) sterilize shared bottles and clean highchair trays before each use when caring for more than one infant.

Proposed new §749.1411, Toddlers: Basic Care Requirements, establishes basic care requirements for toddlers. The rule includes (1) environmental requirements, including (A) keeping the area free of harmful objects, and (B) ensuring electrical outlets are inaccessible; and (2) supervision requirements, including (A) never leaving a toddler unsupervised, and (B) ensuring the toddler is within eyesight or hearing range. The rule allows for the use of video camera or audio monitoring if the caregiver is close enough to intervene as needed.

Proposed new §749.1413, Additional Requirements for Pregnant Children in Care, establishes additional requirements for children in care who are pregnant. The rule requires the CPA to ensure information, training, and counseling is available to the child in care.

Proposed new §749.1415, Additional Requirements for Children in Care Receiving Treatment Services for Primary Medical Needs or Intellectual Disabilities, establishes additional requirements for children in care receiving treatment services for primary medical needs or intellectual disabilities. The rule requires caregivers to (1) follow recommendations from the medical providers for a child in care; and (2) ensure that a child in care receiving treatment services for primary medical needs, or an intellectual disability, has opportunities for physical and sensory stimulation.

Proposed new §749.1417, Discipline and Punishment, establishes discipline and punishment requirements in a foster home. The rule requires that (1) only a caregiver known to a child in care can discipline the child; and (2) all disciplinary measures be consistent with child's rights related to discipline and punishment.

Proposed new §749.1419, Normalcy and Reasonable and Prudent Parent Requirements, requires a foster parent use the reasonable and prudent parent standard to ensure a child in care can participate in childhood activities, including unsupervised activities, which are appropriate in relation to the age and developmental needs of the child in care.

Proposed new §749.1421, Educational Services: General, establishes general educational requirements for children in care. The rule requires the CPA to arrange appropriate education that includes an approved or accredited educational facility or program, and to advocate for a child in care to receive educational and related services to which they are entitled under federal and state law. The rule also requires the CPA to designate a liaison between the CPA and the school for a child in care who receives treatment services.

Proposed new §749.1423, Educational Services: Caregiver Responsibilities, establishes caregiver responsibilities related to education. The rule requires caregivers to (1) request educational meetings with the school if concerns are identified; (2) attend scheduled educational meetings and conferences; and (3) know what is in the Individual Education Plan or Individual Transitional Planning for a child in care.

The proposed repeal of Subchapter M, Foster Homes: Screenings and Verifications, consisting of 749.2401, 749.2403, 749.2405, 749.2407, 749.2445, 749.2447, 749.2449, 749.2451, 749.2453, 749.2470, 749.2473, 749.2475, 749.2477, 749.2479, 749.2481, 749.2483, 749.2485, 749.2487 - 749.2489, 749.2491, 749.2493, 749.2495, 749.2497, 749.2520, 749.2521, 749.2523, 749.2525 - 749.2527, 749.2529, 749.2531, 749.2533, 749.2535, 749.2537, 749.2539, 749.2550, 749.2551, 749.2555, 749.2557, 749.2591, 749.2593, 749.2595, 749.2597, 749.2599, 749.2601, 749.2603, 749.2605, 749.2607, 749.2621, 749.2623, 749.2625, 749.2627, 749.2629, 749.2631, 749.2633, 749.2635, 749.2651, 749.2653, and 749.2655, deletes the subchapter and the rules it contains as the requirements have been consolidated into proposed new Subchapter G, Foster Home Screenings and Verifications.

Proposed new Subchapter N, Medical and Dental Requirements, establishes the requirements for the medical and dental care of a child in care.

Proposed new §749.1501, General Medical, Dental, and Medication Requirements, establishes medical, dental and medication requirements for children in care. The rule requires children in care to have (1) timely routine, emergency, and follow-up care; (2) verification of previous medical and dental exams at admission; and (3) medication administered only by an individual who is trained and authorized. The CPA must ensure caregivers follow orders and recommendations from physicians and other health-care professionals and store medication according to the label's instructions and inaccessible to children in care.

Proposed new §749.1503, Immunizations Requirements, requires the CPA to ensure each child in care meets applicable immunization requirements as specified by the Texas Department of State Health Services.

Proposed new §749.1505, Documentation Requirements for Medical and Dental Care, establishes the documentation requirements for medical and dental care. The rule requires the CPA to maintain documentation of emergency medical and dental visits, immunizations, known contraindicated medications, and insertion of a nasogastric tubes. The rule also requires the foster home to maintain (1) a daily medication log for all prescription medications and any non-prescription medications administered to someone under the age of five, and (2) a record of all medication errors, adverse reactions, and side effects.

The proposed repeal of Subchapter N, Foster Homes: Management and Evaluation, consisting of 749.2801, 749.2803, 749.2805, 749.2807, 749.2809, 749.2811, 749.2813 - 749.2815, 749.2817, 749.2819, 749.2821, 749.2823, 749.2825, and 749.2901 - 749.2905, deletes the subchapter and the rules it contains as the requirements have been consolidated into proposed new Subchapter H, Health and Safety Requirements.

Proposed new Subchapter O, Emergency Behavior Intervention Requirements, establishes requirements for a CPA that allows the use of emergency behavior intervention (EBI).

Proposed new Division 1, Administering Emergency Behavior Intervention, in Subchapter O, establishes requirements for caregivers when administering EBI.

Proposed new §749.1601, Types of Emergency Behavior Intervention (EBI), establishes that a CPA must use a method of EBI that is recognized by CCR. The rule states that EBI may only be used in a situation when preventative de-escalation and redirection was not effective. The rule establishes when a caregiver can use personal restraints, short personal restraints, and emergency medication, and prohibits the use of chemical restraints, mechanical restraints, or seclusion.

Proposed new §749.1603, Administering Emergency Behavior Intervention (EBI) Requirements, requires that during a restraint the caregiver must (1) use the minimal amount of reasonable and necessary physical force, (2) protect the health, safety, and well-being of a child in care, and (3) explain to the child in care what the child needs to do to be released from the personal restraint or short personal restraint.

Proposed new §749.1605, Restraint Minimum Safety Requirements, establishes safety requirements for all personal and short personal restraints. The rule addresses breathing, positioning, and release requirements. The rule requires that the child in care be released after the danger is averted, when the external hazard is no longer present, or when the maximum timeframe is reached.

Proposed new §749.1607, Written Orders for Emergency Medication and Combinations of Emergency Behavior Intervention, establishes that a caregiver may not administer emergency medication or combinations of emergency behavior interventions to a child in care without a written order from a licensed physician or licensed psychiatrist. The rule states the written orders must be given to the parent and all the caregivers of a child in care.

Proposed new Division 2, Follow-Up Actions and Documentation, in Subchapter O, establishes follow-up actions and documentation that must be completed following the implementation of a personal restraint or use of emergency medication.

Proposed new §749.1621, Restraint and Emergency Medication Follow-Up Actions Requirements, establishes how a caregiver must monitor a child in care following use of a personal restraint or emergency medication. The rule establishes topics that must be discussed during the post-intervention discussion. The rule also requires the caregiver to debrief with the child placement staff within 72 hours after the incident.

Proposed new §749.1623, Restraint and Emergency Medication Documentation Requirements, establishes the criteria that caregivers must document following the use of a personal restraint or emergency medication.

Proposed new §749.1625, Post-Restraint and Emergency Medication Parental Notification Requirements, requires a CPA to notify the parent of a child in care no later than 72 hours after a personal restraint or emergency medication is administered. The notification must be written and maintained in the record of the child in care. The rule establishes what must be included in the notice.

Proposed new Division 3, Triggered Reviews and Annual Operation Evaluation, in Subchapter O, establishes a CPA's responsibilities when completing a triggered review and annual review.

Proposed new §749.1631, Triggered Reviews General Requirements, requires a CPA to complete a triggered review of the placement, service plan, and orders or recommendations for EBI for a child in care based on how many times and how frequently the child in care is restrained. The rule establishes that after four triggered reviews in a 90-day period the child in care must be examined by a mental health professional and the CPA must follow the mental health professional's recommendations.

Proposed new §749.1633, Triggered Reviews Documentation Requirements, establishes documentation requirements when a triggered review is completed. The rule requires the documentation to be maintained in the record of the child in care.

Proposed new §749.1635, Annual Operation Evaluation, requires the CPA to conduct an annual operation evaluation to determine that EBI is administered safely, appropriately, and effectively. The rule establishes review and documentation requirements during the annual operation evaluation and reporting requirements to CCR.

The proposed repeal of Subchapter O, Foster Homes: Health and Safety Requirements, Environment, Space and Equipment, consisting of 749.2901 - 749.2905, 749.2907 - 749.2909, 749.2911, 749.2913, 749.2915, 749.2917, 749.2931, 749.2961, 749.2963, 749.2965, 749.2967, 749.3021, 749.3023, 749.3025, 749.3027, 749.3029, 749.3031, 749.3033, 749.3035, 749.3037, 749.3039, 749.3041, 749.3043, 749.3061, 749.3063, 749.3065, 749.3067, 749.3069, 749.3071, 749.3073, 749.3075, 749.3077, 749.3079, 749.3081, 749.3101, 749.3103, 749.3105, 749.3107, 749.3109, 749.3111, 749.3131, 749.3133, 749.3135, 749.3137, 749.3139, 749.3141, 749.3143, 749.3145, 749.3147, 749.3149, and 749.3151, deletes the subchapter and the rules it contains as the requirements have been consolidated into proposed new Subchapter H, Health and Safety Requirements.

FISCAL NOTE

Trey Wood, HHSC Chief Financial Officer, has determined that for each year of the first five years that the rules will be in effect, enforcing or administering the rules does not have foreseeable implications relating to costs or revenues of state or local governments.

GOVERNMENT GROWTH IMPACT STATEMENT

HHSC has determined that during the first five years that the rules will be in effect:

(1) the proposed rules will not create or eliminate a government program;

(2) implementation of the proposed rules will not affect the number of HHSC employee positions;

(3) implementation of the proposed rules will result in no assumed change in future legislative appropriations;

(4) the proposed rules will not affect fees paid to HHSC;

(5) the proposed rules will create new regulations;

(6) the proposed rules will repeal existing regulations;

(7) the proposed rules will not change the number of individuals subject to the rules; and

(8) the proposed rules will not affect the state's economy.

SMALL BUSINESS, MICRO-BUSINESS, AND RURAL COMMUNITY IMPACT ANALYSIS

Trey Wood has also determined that there will be no adverse economic effect on small businesses, micro-businesses, or rural communities because the rules do not impose any additional costs on small businesses, micro-businesses, or rural communities that are required to comply with the rules.

LOCAL EMPLOYMENT IMPACT

The proposed rules will not affect a local economy.

COSTS TO REGULATED PERSONS

Texas Government Code §2001.0045 does not apply to these rules because the rules are necessary to protect the health, safety, and welfare of the residents of Texas; do not impose a cost on regulated persons; and are necessary to implement legislation that does not specifically state that §2001.0045 applies to the rules.

PUBLIC BENEFIT AND COSTS

Rachel Ashworth-Mazerolle, Associate Commissioner for Child Care Regulation, has determined that for each year of the first five years the rules are in effect the public benefit will be (1) regulatory requirements that reflect current research, best practices, and guidelines around child safety and well-being, and confidentiality; (2) elimination of requirements that are outdated, redundant, or unnecessarily burdensome; (3) streamlined and improved requirements that are necessary to protect the health, safety and well-being of children; and (4) rules that comply with state law.

Trey Wood has also determined that for the first five years the rules are in effect, there are no anticipated economic costs to persons who are required to comply with the proposed rules because the rules do not impose fees and are an overall reduction in regulatory oversight and requirements.

TAKINGS IMPACT ASSESSMENT

HHSC has determined that the proposal does not restrict or limit an owner's right to the owner's property that would otherwise exist in the absence of government action and, therefore, does not constitute a taking under Texas Government Code §2007.043.

PUBLIC COMMENT

Written comments on the proposal, including information related to the cost, benefit, or effect of the proposed rule, as well as any applicable data, research, or analysis, may be submitted to Rules Coordination Office, P.O. Box 13247, Mail Code 4102, Austin, Texas 78711-3247, or street address 4601 West Guadalupe Street, Austin, Texas 78751; or emailed to HHSRulesCoordinationOffice@hhs.texas.gov.

To be considered, comments must be submitted no later than 31 days after the date of this issue of the Texas Register. Comments must be (1) postmarked or shipped before the last day of the comment period; (2) hand-delivered before 5:00 p.m. on the last working day of the comment period; or (3) emailed before midnight on the last day of the comment period. If the last day to submit comments falls on a holiday, comments must be postmarked, shipped, or emailed before midnight on the following business day to be accepted. When emailing comments, please indicate "Comments on Proposed Rule 25R029" in the subject line.

SUBCHAPTER F. TRAINING AND PROFESSIONAL DEVELOPMENT

DIVISION 1. DEFINITIONS

26 TAC §749.801

STATUTORY AUTHORITY

The repealed section is authorized by Texas Government Code §542.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services agencies, and Texas Government Code §524.0005, which provides the executive commissioner of HHSC with broad rulemaking authority. In addition, HRC §42.042(a) requires HHSC to adopt rules to carry out the requirements of Texas Human Resources Code Chapter 42.

The repealed section affects Texas Government Code §524.0151 and HRC §42.042.

§749.801. What do certain words and terms mean in this subchapter?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600417

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 2. OVERVIEW OF TRAINING AND EXPERIENCE REQUIREMENTS

26 TAC §749.811, §749.813

STATUTORY AUTHORITY

The repealed sections are authorized by Texas Government Code §542.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services agencies, and Texas Government Code §524.0005, which provides the executive commissioner of HHSC with broad rulemaking authority. In addition, HRC §42.042(a) requires HHSC to adopt rules to carry out the requirements of Texas Human Resources Code Chapter 42.

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.811. What are the training and experience requirements for a caregiver?

§749.813. What are the training requirements for an employee?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600418

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 3. ORIENTATION

26 TAC §749.831, §749.833

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.831. What is the orientation requirement for caregivers and employees?

§749.833. When may a caregiver or employee be exempt from orientation?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600419

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 4. PRE-SERVICE EXPERIENCE AND TRAINING

26 TAC §§749.861, 749.863 - 749.865, 749.867 - 749.869

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.861. What are the pre-service experience requirements for caregivers?

§749.863. What are the pre-service training requirements for a caregiver?

§749.864. What are the pre-service training requirements for an employee?

§749.865. Can time spent in orientation training count towards pre-service training?

§749.867. What caregivers or employees are exempt from certain pre-service training requirements?

§749.868. Can a child-placing agency waive pre-service training requirements for a foster parent?

§749.869. How must pre-service training be conducted?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600420

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 5. CURRICULUM COMPONENTS FOR PRE-SERVICE TRAINING

26 TAC §§749.881 - 749.883, 749.885, 749.887, 749.889

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.881. What curriculum components must be included in the general pre-service training?

§749.882. What curriculum components must be included in the pre-service training for normalcy?

§749.883. What curriculum components must be included in the pre-service training for safe sleeping?

§749.885. What curriculum components must be included in the pre-service training for administering psychotropic medication?

§749.887. If I do not allow the use of emergency behavior intervention, what curriculum components must be included in the pre-service training for emergency behavior intervention?

§749.889. If I allow the use of emergency behavior intervention, what curriculum components must be included in the pre-service training for emergency behavior intervention?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600421

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 6. PEDIATRIC FIRST AID AND PEDIATRIC CPR CERTIFICATION

26 TAC §§749.911, 749.913, 749.915

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.911. Who must have pediatric first aid and pediatric CPR training?

§749.913. Are there any exemptions from pediatric first aid and pediatric CPR certification?

§749.915. What documentation must I maintain for pediatric first-aid and pediatric CPR certifications?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600422

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 7. ANNUAL TRAINING

26 TAC §§749.930 - 749.933, 749.935, 749.937, 749.939

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.930. What are the annual training requirements for a caregiver?

§749.931. What are the annual training requirements for an employee?

§749.932. What exemptions or waivers may apply to the annual training requirements for a caregiver?

§749.933. When must an employee or caregiver complete the annual training?

§749.935. What types of hours or instruction can be used to complete the annual training requirements?

§749.937. Does Licensing approve training resources or trainers for annual training hours?

§749.939. How must annual training be conducted?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600423

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 8. TOPICS AND CURRICULUM COMPONENTS FOR ANNUAL TRAINING

26 TAC §§749.941, 749.943 - 749.945, 749.947, 749.949

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.941. What areas or topics are appropriate for annual training?

§749.943. What curriculum components must be included in the annual training for normalcy?

§749.944. What curriculum components must be included in the annual training for employees on the prevention, recognition, and reporting of child abuse, neglect, and exploitation?

§749.945. What curriculum components must be included in the annual training for administering psychotropic medication?

§749.947. What curriculum components must be included in the annual training for emergency behavior intervention?

§749.949. What documentation must I maintain for annual training?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600424

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

SUBCHAPTER G. CHILDREN'S RIGHTS

26 TAC §§749.1001, 749.1003, 749.1005, 749.1007, 749.1009, 749.1011, 749.1013, 749.1015, 749.1017, 749.1019, 749.1021

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1001. How must I protect the rights of children served by my child-placing agency?

§749.1003. What rights does a child in care have?

§749.1005. How must I inform a child and the child's parents of their rights?

§749.1007. What are a child's rights regarding education?

§749.1009. What right does a child have regarding contact with a parent?

§749.1011. What right does a child have regarding contact with siblings?

§749.1013. What right to privacy does a child have with respect to his contact with others?

§749.1015. Under what circumstances may I conduct a search for prohibited items or items that endanger a child's safety?

§749.1017. May a caregiver conduct a body cavity search of a child in care?

§749.1019. What must a caregiver document regarding a search?

§749.1021. What techniques am I prohibited from using on a child?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600425

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

SUBCHAPTER H. FOSTER CARE SERVICES: ADMISSION AND PLACEMENT

DIVISION 1. ADMISSIONS

26 TAC §§749.1101, 749.1103, 749.1105, 749.1107, 749.1109, 749.1111, 749.1113, 749.1115

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1101. Who may I admit?

§749.1103. After a child in my care turns 18 years old, may the person remain in my care?

§749.1105. May I admit a young adult into care?

§749.1107. What information must I document in the child's record at the time of admission?

§749.1109. What is a placement agreement?

§749.1111. What orientation must I provide a child?

§749.1113. What information must I share with the parent at the time of placement?

§749.1115. What information must I provide caregivers when I admit a child?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600426

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 2. ADMISSION ASSESSMENT

26 TAC §§749.1131, 749.1133, 749.1135, 749.1137

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1131. When must I complete the admission assessment?

§749.1133. What information must an admission assessment include?

§749.1135. What are the additional admission assessment requirements when I admit a child for treatment services?

§749.1137. What if I cannot obtain the required information for an admission assessment?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600427

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 3. REQUIRED ADMISSION INFORMATION

26 TAC §§749.1151, 749.1153, 749.1155

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1151. What are the medical requirements when I admit a child into care?

§ 749.1153. What are the dental requirements when I admit a child into care?

§749.1155. What must I document when I re-admit a child for care?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600428

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 4. EMERGENCY ADMISSION

26 TAC §§749.1181, 749.1183, 749.1185, 749.1187, 749.1189

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1181. For which of my programs may I accept emergency admissions?

§749.1183. What constitutes an emergency admission to my child-placing agency?

§749.1185. May I take possession of a child from a law enforcement officer?

§749.1187. For an emergency admission, when must I complete all of the requirements for an admission assessment?

§749.1189. At the time of an emergency admission, what information must I document in the child's record?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600429

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 5. FOSTER CARE PLACEMENT

26 TAC §§749.1251, 749.1253, 749.1255

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1251. What are the requirements for pre-placement visits for a child?

§749.1253. What must staff do to prepare a child for a placement?

§749.1255. What information from an admission assessment must I share with the caregivers responsible for the child's care?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600430

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 6. SUBSEQUENT PLACEMENT

26 TAC §749.1281

STATUTORY AUTHORITY

The repealed section affects Texas Government Code §524.0151 and HRC §42.042.

§749.1281. What are the requirements when I move a child from one foster home to another?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600431

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 7. POST-PLACEMENT CONTACT

26 TAC §749.1291

STATUTORY AUTHORITY

The repealed section affects Texas Government Code §524.0151 and HRC §42.042.

§749.1291. What are the requirements for contact between child placement staff and children in foster care?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600432

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

SUBCHAPTER I. FOSTER CARE SERVICES: SERVICE PLANNING, DISCHARGE

DIVISION 1. SERVICE PLANS

26 TAC §§749.1301, 749.1305, 749.1307, 749.1309, 749.1311 - 749.1313, 749.1315, 749.1317, 749.1319, 749.1321, 749.1323

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1301. What are the requirements for a preliminary service plan?

§749.1305. Who must be involved in developing the preliminary service plan?

§749.1307. When must I complete an initial service plan?

§749.1309. What must a child's initial service plan include?

§749.1311. Who must be involved in developing an initial service plan?

§749.1312. Can the service planning team discuss and develop a child's service plan in separate meetings?

§749.1313. When must I inform the child's parents and foster parents of an initial service plan meeting?

§749.1315. Must a professional service provider or a professional who must participate in a child's service plan be an employee of my agency?

§749.1317. What roles do professional service providers have in service planning?

§749.1319. What must I document regarding a professional service provider's participation in the development of an initial service plan?

§749.1321. With whom do I share the initial service plan?

§749.1323. When must I implement a service plan?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600433

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 2. SERVICE PLAN REVIEW AND UPDATES

26 TAC §§749.1331, 749.1333, 749.1335 - 749.1337, 749.1339

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1331. How often must I review and update a service plan?

§749.1333. How does a child's transfer affect the timing of the review of the child's service plan?

§749.1335. How do I review and update a service plan?

§749.1336. Can the child-placing agency continue to review and update a child's previous service plan without creating a new service plan?

§749.1337. Are the notification, participation, implementation, and documentation requirements for a service plan review and update the same as for an initial service plan?

§749.1339. How often must I re-evaluate the intellectual functioning of a child receiving treatment services for intellectual disabilities?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600434

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 3. DISCHARGE AND TRANSFER PLANNING

26 TAC §§749.1361, 749.1363, 749.1365, 749.1367, 749.1369, 749.1371, 749.1373, 749.1377

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1361. What does a "transfer" of a child in care mean?

§749.1363. Who must plan a child's non-emergency discharge or transfer?

§749.1365. May a foster home release a child to any person without my consent?

§749.1367. To whom can I discharge a child in a non-emergency situation?

§749.1369. How do I discharge or transfer a child who is an immediate danger to self or others?

§749.1371. What must I document in the child's record at the time of a discharge or transfer?

§749.1373. When I discharge a child, what information must I provide to the next placement or caregiver?

§749.1377. What constitutes an emergency discharge or transfer?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600435

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

SUBCHAPTER J. FOSTER CARE SERVICES: MEDICAL AND DENTAL

DIVISION 1. MEDICAL AND DENTAL CARE

26 TAC §§749.1401, 749.1403, 749.1405, 749.1409, 749.1411, 749.1413, 749.1415, 749.1417, 749.1421, 749.1423, 749.1425, 749.1427, 749.1429, 749.1431, 749.1433, 749.1435, 749.1437

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1401. What general medical requirements must my agency meet?

§749.1403. Who determines the need and frequency for ongoing maintenance of medical care and treatment for a child?

§749.1405. Who must perform medical care examinations and provide medical treatment for a child?

§749.1409. What general dental requirements must my agency meet?

§749.1411. Who must determine the frequency and need for ongoing maintenance of dental health for a child?

§749.1413. Who must perform dental examinations and provide dental treatment?

§749.1415. What health precautions must I take if a person in care, employee, caregiver, someone else in one of my foster homes, or someone else in my agency has a communicable disease?

§749.1417. Who must have a tuberculosis (TB) examination?

§749.1421. What immunizations must a child in my care have?

§749.1423. What exemptions or exceptions are there concerning immunization requirements?

§749.1425. What documentation is acceptable for an immunization record?

§749.1427. Must children in my care have a vision and hearing screening?

§749.1429. What must I do if a child in my care is identified as needing a diagnostic vision or hearing examination?

§749.1431. What special equipment must I provide for a child with a physical disability?

§749.1433. How often must the physician review a child's primary medical needs?

§749.1435. What are the requirements for using a nasogastric tube?

§749.1437. How must a caregiver respond when a child is injured or ill and requires immediate treatment by a health-care professional?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600436

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 2. ADMINISTRATION OF MEDICATION

26 TAC §§749.1461, 749.1463, 749.1469

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1461. What consent must I obtain to administer medications?

§749.1463. What are the requirements for administering prescription medication?

§749.1469. What are the requirements for administering non-prescription medication and supplements?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600437

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 3. SELF-ADMINISTRATION OF MEDICATION

26 TAC §749.1501, §749.1503

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1501. What are the requirements for a self-medication program?

§749.1503. Who must record the medication dosage if the child is on a self-medication program?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600438

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 4. MEDICATION STORAGE AND DESTRUCTION

26 TAC §749.1521

STATUTORY AUTHORITY

The repealed section affects Texas Government Code §524.0151 and HRC §42.042.

§749.1521. What medication storage and destruction requirements must a foster home meet?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600439

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 5. MEDICATION RECORDS

26 TAC §§749.1541, 749.1543, 749.1545

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1541. What records must caregivers maintain for each child receiving medication?

§749.1543. Where must a child's medication records be maintained?

§749.1545. What other requirements must I meet regarding medication records?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600440

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 6. MEDICATION AND LABEL ERRORS

26 TAC §§749.1561, 749.1563, 749.1565

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1561. What is a medication error?

§749.1563. What must a caregiver do if the caregiver finds a medication error?

§749.1565. What must a caregiver do if the caregiver finds a medication label error?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600441

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 7. SIDE EFFECTS AND ADVERSE REACTIONS TO MEDICATION

26 TAC §749.1581, §749.1583

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1581. What must a caregiver do if a child has an adverse reaction to a medication?

§749.1583. What must a caregiver do if a child experiences side effects from any medications?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600442

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 8. USE OF PSYCHOTROPIC MEDICATION

26 TAC §§749.1603, 749.1605, 749.1607, 749.1609, 749.1611

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1603. If my agency employs or contracts with a health-care professional who prescribes psychotropic medications to a child in care, what information must I provide the person legally authorized to give consent before requesting his consent for the child to be placed on psychotropic medication?

§749.1605. If my agency does not employ or contract with the health-care professional who prescribes psychotropic medications to a child in care, what information must I provide the person legally authorized to give medical consent prior to the health-care professional prescribing psychotropic medications to a child in care?

§749.1607. What are the requirements if a physician orders administration of a psychotropic medication to a child in an emergency?

§749.1609. What information must be documented about a child's use of psychotropic medication?

§749.1611. If my agency employs or contracts with a health-care professional who prescribes psychotropic medications to a child in care, what are the requirements for evaluating whether a child should continue taking a psychotropic medication?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600443

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 9. PROTECTIVE DEVICES

26 TAC §§749.1641, 749.1643, 749.1645, 749.1647

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1641. What is a protective device?

§749.1643. What does "involuntary self-injurious behavior" mean when used in this division?

§749.1645. May I use protective devices?

§749.1647. Who may use PRN orders with respect to protective devices?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600444

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 10. SUPPORTIVE DEVICES

26 TAC §§749.1671, 749.1673, 749.1675

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1671. What is a supportive device?

§749.1673. May I use supportive devices?

§749.1675. Who may use PRN orders with respect to supportive devices?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600445

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

SUBCHAPTER K. FOSTER CARE SERVICES: DAILY CARE, PROBLEM MANAGEMENT

DIVISION 1. ADDITIONAL REQUIREMENTS FOR INFANT CARE

26 TAC §§749.1801, 749.1803, 749.1805, 749.1807, 749.1809, 749.1811, 749.1813, 749.1815, 749.1817, 749.1819, 749.1821

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1801. What do certain words mean in this division?

§749.1803. What are the basic care requirements for an infant?

§749.1805. What furnishings and equipment must I have in an infant care area?

§749.1807. What specific safety requirements must my cribs meet?

§749.1809. Are mesh cribs or port-a-cribs allowed?

§749.1811. What equipment must have safety straps before I can use it with an infant?

§749.1813. What types of equipment may a foster home not use with infants?

§749.1815. What are the specific sleeping requirements for infants?

§749.1817. May I allow an infant to sleep in a restrictive device?

§749.1819. What are the specific requirements for feeding an infant?

§749.1821. May I swaddle an infant to help the infant sleep?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600446

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 2. ADDITIONAL REQUIREMENTS FOR TODDLER CARE

26 TAC §749.1841

STATUTORY AUTHORITY

The repealed section affects Texas Government Code §524.0151 and HRC §42.042.

§749.1841. What are the basic care requirements for a toddler?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600447

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 3. ADDITIONAL REQUIREMENTS FOR PREGNANT CHILDREN

26 TAC §§749.1861, 749.1863, 749.1865

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1861. What information must I provide a pregnant child regarding her pregnancy?

§749.1863. Is the use of emergency behavior intervention of a pregnant child permitted in a foster home?

§749.1865. If my policies permit the admission of adolescent parents with their child(ren), who is responsible for the care of an adolescent's child?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600448

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 4. EDUCATIONAL SERVICES

26 TAC §§749.1891, 749.1893, 749.1895

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1891. What responsibilities do I have for the education of a child in care?

§749.1893. What responsibilities do caregivers have for the educational needs of a child in their care?

§749.1895. What are the specific requirements for the educational program of a child diagnosed with autism spectrum disorder?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600449

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 5. RECREATIONAL SERVICES

26 TAC §§749.1921, 749.1923, 749.1925, 749.1927

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1921. What responsibilities do foster parents have for providing a child with opportunities for recreational activities?

§749.1923. What physical fitness activities must caregivers provide for a child receiving treatment services for primary medical needs or intellectual disability?

§749.1925. What type of daily schedule must caregivers provide for a child receiving treatment services for primary medical needs or intellectual disability?

§749.1927. To what extent must a child receiving treatment services for primary medical needs or intellectual disabilities have normal life experiences?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600450

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 6. DISCIPLINE AND PUNISHMENT

26 TAC §§749.1951, 749.1953, 749.1955, 749.1957, 749.1959, 749.1961

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1951. What are the requirements for disciplinary measures?

§749.1953. May I use corporal punishment for children in care?

§749.1955. What is "unproductive work"?

§749.1957. What other methods of punishment are prohibited?

§749.1959. To what extent may a caregiver restrict a child's activities as a behavior management tool?

§749.1961. May a person in care discipline or punish another person in care?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600451

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

SUBCHAPTER L. FOSTER CARE SERVICES: EMERGENCY BEHAVIOR INTERVENTION

DIVISION 1. DEFINITIONS

26 TAC §749.2001

STATUTORY AUTHORITY

The repealed section affects Texas Government Code §524.0151 and HRC §42.042.

§749.2001. What do certain terms mean in this subchapter?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600452

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 2. TYPES OF EMERGENCY BEHAVIOR INTERVENTION THAT MAY BE ADMINISTERED

26 TAC §§749.2051, 749.2053, 749.2055, 749.2059, 749.2061, 749.2063

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2051. What types of emergency behavior intervention may I administer?

§749.2053. Who may administer emergency behavior intervention?

§749.2055. What actions must a caregiver take before using a permitted type of emergency behavior intervention?

§749.2059. What is the appropriate use for a short personal restraint?

§749.2061. What precautions must a caregiver take when implementing a short personal restraint?

§749.2063. Are there any purposes for which emergency behavior intervention cannot be used?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600453

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 3. ORDERS

26 TAC §§749.2101, 749.2103, 749.2105, 749.2107

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2101. Are written orders required to administer emergency behavior intervention, and if so, who can write them?

§749.2103. Must the written order be in a child's record before a caregiver can use an emergency behavior intervention on a child?

§749.2105. What information must a written order include?

§749.2107. Under what conditions are PRN orders permitted for a specific child?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600454

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 4. RESPONSIBILITIES DURING ADMINISTRATION OF ANY TYPE OF EMERGENCY BEHAVIOR INTERVENTION

26 TAC §749.2151, §749.2153

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2151. What responsibilities does a caregiver have when implementing a type of emergency behavior intervention?

§749.2153. When must a caregiver release a child from an emergency behavior intervention?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600455

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 5. ADDITIONAL RESPONSIBILITIES DURING ADMINISTRATION OF A PERSONAL RESTRAINT

26 TAC §§749.2201, 749.2203, 749.2205

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2201. Who must monitor a personal restraint?

§749.2203. What is the appropriate action for a caregiver to take to ensure the child's adequate respiration, circulation, and overall well-being?

§749.2205. What personal restraint techniques are prohibited?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600456

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 6. COMBINATIONS OF EMERGENCY BEHAVIOR INTERVENTION

26 TAC §749.2231, §749.2233

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2231. May a caregiver successively use emergency behavior interventions on a child?

§749.2233. May a caregiver simultaneously use emergency medication in combination with personal restraint?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600457

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 7. TIME RESTRICTIONS FOR EMERGENCY BEHAVIOR INTERVENTION

26 TAC §749.2281, §749.2283

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2281. What is the maximum length of time that an emergency behavior intervention can be administered to a child?

§749.2283. Can a caregiver exceed the maximum length of time that an emergency behavior intervention can be administered to a child?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600458

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 8. GENERAL CAREGIVER RESPONSIBILITIES, INCLUDING DOCUMENTATION, AFTER THE ADMINISTRATION OF EMERGENCY BEHAVIOR INTERVENTION

26 TAC §§749.2301, 749.2303, 749.2305, 749.2307

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2301. What follow-up actions must caregivers take after the child's behavior no longer constitutes an emergency situation?

§749.2303. What must the caregiver document after discussing with the child the use of the emergency behavior intervention?

§749.2305. When must a caregiver document the use of an emergency behavior intervention, and what must the documentation include?

§749.2307. What notice must I provide to the parent when I use an emergency behavior intervention with a child in care?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600459

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 9. TRIGGERED REVIEWS

26 TAC §§749.2331, 749.2333, 749.2335, 749.2337, 749.2339

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2331. What circumstances trigger a review of the use of emergency behavior intervention for a specific child?

§749.2333. When must a triggered review occur?

§749.2335. Who must participate in the triggered review?

§749.2337. What must the triggered review include and what must be documented in the child's record?

§749.2339. What if there are four triggered reviews within a 90-day period?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600460

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 10. OVERALL OPERATION EVALUATION

26 TAC §749.2381, §749.2383

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2381. What is an overall agency evaluation?

§749.2383. What data must be collected?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600461

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

SUBCHAPTER M. FOSTER HOMES: SCREENINGS AND VERIFICATIONS

DIVISION 1. GENERAL REQUIREMENTS

26 TAC §§749.2401, 749.2403, 749.2405, 749.2407

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2401. In what circumstances may I verify an individual spouse as a foster parent?

§749.2403. What minimum age requirement must foster parents and caregivers meet?

§749.2405. Will my home have to be re-verified if I am a single foster parent and I get married after my home is verified?

§749.2407. May a home be verified or approved by more than one child-placing agency simultaneously?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600462

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 2. FOSTER HOME SCREENINGS

26 TAC §§749.2445, 749.2447, 749.2449, 749.2451, 749.2453

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2445. What is a foster home screening?

§749.2447. What information must I obtain for the foster home screening?

§749.2449. Whom must I interview when conducting a foster home screening?

§749.2451. What must I document regarding interviews I conduct for a foster home screening?

§749.2453. When must I update the foster home screening?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600463

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 3. VERIFICATION OF FOSTER HOME

26 TAC §§749.2470, 749.2473, 749.2475, 749.2477, 749.2479, 749.2481, 749.2483, 749.2485, 749.2487 - 749.2489, 749.2491, 749.2493, 749.2495, 749.2497

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2470. What must I do to verify a foster family home?

§749.2473. What must I do to verify a foster home that another child-placing agency has previously verified?

§749.2475. To whom must I release information regarding a family on which I previously conducted a foster home screening, pre-adoptive home screening, or post placement adoptive report?

§749.2477. May I verify a foster home prior to approval by child placement management staff?

§749.2479. May I place children in a foster home before verifying the home?

§749.2481. What type of certificate must a foster home have in order to prove verification?

§749.2483. Do foster parent applicants have to own the home they live in for it to be their primary residence?

§749.2485. What are the requirements for verifying a foster home at a residence that I own?

§749.2487. What are the requirements for an agreement that I have with a foster home that I verify?

§749.2488. What statement must I provide to foster parents regarding foster parent and child-placing agency rights and responsibilities?

§749.2489. What information must I submit to Licensing about a foster home's verification status?

§749.2491. May I verify a foster home to provide different services?

§749.2493. May a foster home provide day care in addition to foster care?

§749.2495. Do foster home verifications expire?

§749.2497. What requirements are there for a transfer or closing summary?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600464

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 4. TEMPORARY, TIME-LIMITED, AND PROVISIONAL VERIFICATIONS

26 TAC §§749.2520, 749.2521, 749.2523, 749.2525 - 749.2527, 749.2529, 749.2531, 749.2533, 749.2535, 749.2537, 749.2539

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2520. What is the purpose of a temporary verification?

§749.2521. What must I do prior to issuing a temporary verification?

§749.2523. For what length of time can I issue a temporary verification?

§749.2525. Can foster children remain in the foster home while a temporary verification is in effect?

§749.2526. What is the purpose of a time-limited verification?

§749.2527. What must I do to issue a time-limited verification?

§749.2529. For what length of time may I issue a time-limited verification?

§749.2531. Can I extend a time-limited verification or change the verification from time-limited to non-expiring?

§749.2533. What is the purpose of a provisional verification?

§749.2535. What must I do prior to issuing a provisional verification?

§749.2537. For what length of time can I issue a provisional verification?

§749.2539. Can foster children remain in the foster home while a provisional verification is in effect?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600465

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 5. CAPACITY AND CHILD/CAREGIVER RATIO

26 TAC §§749.2550, 749.2551, 749.2555, 749.2557

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2550. What does "children with primary medical needs requiring total care" mean when used in this Division?

§749.2551. What is the maximum number of children a foster family home may care for?

§749.2555. How do I determine capacity?

§749.2557. May a foster home exceed its verified capacity?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600466

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 6. SUPERVISION

26 TAC §§749.2591, 749.2593, 749.2595, 749.2597, 749.2599

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2591. How am I responsible for ensuring adequate supervision of children in care?

§749.2593. What responsibilities does a caregiver have when supervising a child?

§749.2595. May I use a video camera to supervise a child in the child's bedroom?

§749.2597. Where must the caregivers reside in order to supervise children who are in a transitional living program?

§749.2599. Can a child serve as a babysitter?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600467

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 7. NORMALCY

26 TAC §§749.2601, 749.2603, 749.2605, 749.2607

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2601. What is "normalcy"?

§749.2603. Are children in care required to participate in childhood activities?

§749.2605. What is the "reasonable and prudent parent standard"?

§749.2607. Who makes the decision regarding a foster child's participation in childhood activities?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600468

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 8. RESPITE CHILD-CARE SERVICES

26 TAC §§749.2621, 749.2623, 749.2625, 749.2627, 749.2629, 749.2631, 749.2633, 749.2635

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2621. What are respite child-care services?

§749.2623. What must occur before I place a child for respite child-care services?

§749.2625. What information regarding the child must I share with the babysitter, overnight care provider, and respite care provider?

§749.2627. What must occur before one of my foster homes accepts a child for respite child-care service?

§749.2629. In addition to the requirements of this division, what requirements of this chapter apply to respite child-care services that a foster home provides?

§749.2631. How long may a child be in respite child-care services?

§749.2633. How frequently may a foster home provide respite child-care services?

§749.2635. May I place a child for babysitting, overnight care, or respite care services in a home that Licensing does not regulate?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600469

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 9. AGENCY--FOSTER FAMILY RELATIONSHIPS

26 TAC §§749.2651, 749.2653, 749.2655

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2651. May a foster home accept adults into the home for care?

§749.2653. What are the requirements for an unrelated adult to reside in a foster home?

§749.2655. When must a foster home notify you of changes that affect the foster home?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600470

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

SUBCHAPTER N. FOSTER HOMES: MANAGEMENT AND EVALUATION

26 TAC §§749.2801, 749.2803, 749.2805, 749.2807, 749.2809, 749.2811, 749.2813 - 749.2815, 749.2817, 749.2819, 749.2821, 749.2823, 749.2825

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2801. When must I evaluate a foster home for compliance with Licensing rules?

§749.2803. What changes affect a foster home's verification?

§749.2805. What is a "major life change in the foster family"?

§749.2807. How do I evaluate a foster home's compliance with the relevant Licensing rules affecting the need for the evaluation?

§749.2809. What must a plan for achieving compliance include?

§749.2811. How do I follow-up to ensure compliance?

§749.2813. How do I evaluate Licensing rules for each home every two years?

§749.2814. How do I evaluate a foster home prior to extending its time-limited verification or changing its verification from time-limited to non-expiring?

§749.2815. How often must I have supervisory visits with the foster home and what must be evaluated during a supervisory visit?

§749.2817. Must I monitor and have supervisory visits with a foster home where no children are placed?

§749.2819. When may I place a foster home on inactive status?

§749.2821. How do the foster parents meet their training requirements while their home is on inactive status?

§749.2823. Are background checks required on homes that are on inactive status?

§749.2825. How do I take a foster home off inactive status?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600471

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

SUBCHAPTER O. FOSTER HOMES: HEALTH AND SAFETY REQUIREMENTS, ENVIRONMENT, SPACE AND EQUIPMENT

DIVISION 1. HEALTH AND SAFETY

26 TAC §§749.2901 - 749.2905, 749.2907 - 749.2909, 749.2911, 749.2913, 749.2915, 749.2917

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2901. What health and safety regulations must each foster home meet in addition to Licensing rules?

§749.2902. What health and safety measures are required at a foster home?

§749.2903. What fire safety measures are required at a foster family home not serving children receiving treatment services for primary medical needs?

§749.2904. What fire safety measures are required at a foster family home serving children receiving treatment services for primary medical needs?

§749.2905. How often must fire and health inspections be conducted at a foster home?

§749.2907. What disaster and emergency plans must each foster home have?

§749.2908. How must a foster home practice disaster and emergency plans?

§749.2909. How many smoke detectors must a foster home have?

§749.2911. How must smoke detectors be installed and maintained at a foster home?

§749.2913. How many fire extinguishers must a foster home have?

§749.2915. Where must a foster home store dangerous tools and equipment?

§749.2917. What are the requirements for animals that are present at a foster home?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600472

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 2. TOBACCO AND E-CIGARETTE USE

26 TAC §749.2931

STATUTORY AUTHORITY

The repealed section affects Texas Government Code §524.0151 and HRC §42.042.

§749.2931. What policies must I enforce regarding tobacco products and e-cigarettes?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600473

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 3. WEAPONS, FIREARMS, EXPLOSIVE MATERIALS, AND PROJECTILES

26 TAC §§749.2961, 749.2963, 749.2965, 749.2967

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.2961. Are weapons, firearms, explosive materials, and projectiles permitted in a foster home?

§749.2963. What factors must I consider when determining whether weapons, firearms, explosive materials, or projectiles are stored adequately?

§749.2965. How must I determine whether weapons, firearms, explosive materials, or projectiles are present in a foster home?

§749.2967. May a caregiver transport a child in a vehicle where firearms, other weapons, explosive materials, or projectiles are present?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600474

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 4. SPACE AND EQUIPMENT

26 TAC §§749.3021, 749.3023, 749.3025, 749.3027, 749.3029, 749.3031, 749.3033, 749.3035, 749.3037, 749.3039, 749.3041, 749.3043

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.3021. How much space must bedrooms used by foster children have?

§749.3023. Which rooms in the home may not be used as bedrooms?

§749.3025. May an adult in care share a bedroom with a child in care?

§749.3027. May a child in care share a bedroom with an adult caregiver in the foster home?

§749.3029. May children of opposite genders share a bedroom?

§749.3031. What are the requirements for beds and bedding?

§749.3033. What type of personal storage space must a foster child have?

§749.3035. What bathroom accommodations must a home have?

§749.3037. What are the requirements for indoor space that children can use?

§749.3039. What are the requirements for outdoor recreation equipment?

§749.3041. What are the requirements for a foster home's physical environment?

§749.3043. When is a product considered unsafe and what are a caregiver's responsibilities regarding unsafe products in a foster home?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600475

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 5. NUTRITION AND FOOD PREPARATION

26 TAC §§749.3061, 749.3063, 749.3065, 749.3067, 749.3069, 749.3071, 749.3073, 749.3075, 749.3077, 749.3079, 749.3081

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.3061. What are the requirements for feeding children in care?

§749.3063. What types of food and water must caregivers provide children?

§749.3065. What must the caregiver do if a child refuses to or cannot eat a meal or snack that is offered?

§749.3067. May a caregiver use food as a reward or punishment or as part of any behavior management program?

§749.3069. May caregivers offer a child in care different food choices than what the family is eating?

§749.3071. What must I do if a child requires a therapeutic or special diet?

§749.3073. What are the nutrition requirements for a child with primary medical needs?

§749.3075. What are the feeding requirements for children receiving treatment services for primary medical needs or intellectual disabilities?

§749.3077. What are the requirements for tube-feeding formula?

§749.3079. What are the requirements for storing food?

§749.3081. How must kitchen, dining areas, supplies, and equipment be maintained?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600476

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 6. TRANSPORTATION

26 TAC §§749.3101, 749.3103, 749.3105, 749.3107, 749.3109, 749.3111

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.3101. What are the requirements for the vehicles used to transport foster children?

§749.3103. What are the requirements for transporting foster children?

§749.3105. May children transport other foster children?

§749.3107. May caregivers teach or supervise foster children in learning to drive?

§749.3109. What are the special requirements for transporting a child who requires increased supervision or is non-ambulatory or non-mobile?

§749.3111. Do the seat belt requirements prohibit transporting children in the bed of a pick-up truck or other parts of the vehicle on the foster parents' property or public roads?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600477

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 7. SWIMMING POOLS, BODIES OF WATER, SAFETY

26 TAC §§749.3131, 749.3133, 749.3135, 749.3137, 749.3139, 749.3141, 749.3143, 749.3145, 749.3147, 749.3149, 749.3151

STATUTORY AUTHORITY

The repealed sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.3131. Who is responsible for complying with the requirements in this subchapter?

§749.3133. What are the requirements for a swimming pool at a foster home?

§749.3135. What general requirements must caregivers meet for children regarding a body of water?

§749.3137. What are the child/adult ratios for swimming activities?

§749.3139. May I include volunteers or relatives who do not meet minimum qualifications for caregivers in the swimming child/adult ratio?

§749.3141. When must a child wear a life jacket?

§749.3143. Must persons who are counted in the swimming child/adult ratio know how to swim and carry out a water rescue?

§749.3145. What are the safety requirements for wading pools?

§749.3147. What are the requirements for a hot tub?

§749.3149. What must I document regarding a body of water that is on or adjacent and accessible to the premises of a foster home?

§749.3151. Can foster parents approve a child to participate in swimming activities as an unsupervised childhood activity without complying with the rules of this division?

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600478

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

SUBCHAPTER F. TRAINING REQUIREMENTS

DIVISION 1. CAREGIVER TRAINING REQUIREMENTS

26 TAC §§749.801, 749.803, 749.805, 749.807

STATUTORY AUTHORITY

The new sections are authorized by Texas Government Code §542.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services agencies, and Texas Government Code §524.0005, which provides the executive commissioner of HHSC with broad rulemaking authority. In addition, HRC §42.042(a) requires HHSC to adopt rules to carry out the requirements of Texas Human Resources Code Chapter 42.

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.801. Caregiver Pre-Verification Training Requirements.

Prior to foster home verification, the CPA must ensure each caregiver completes pre-verification training that includes:

(1) an overview of the relevant and applicable laws and rules of this chapter;

(2) the CPA's philosophy, organizational structure, policies, services, and programs the CPA provides;

(3) a review of the reasonable and prudent parent standard, and how the standard ensures child safety;

(4) a review of the CPA and foster parent verification agreements; and

(5) a review of the Child Care Regulation Statement of Foster Parent and Child-Placing Agency Rights and Responsibilities form, or a form created by the CPA with the same information.

§749.803. General Caregiver Training Requirements.

(a) Before a child-placing agency (CPA) places a child in the care of the foster home (home), at least one foster parent must complete:

(1) four hours of general caregiver training;

(2) six hours emergency behavior intervention training (EBI); and

(3) safe sleeping training, if the foster home will care for a child in care younger than two years old.

(b) Other caregivers, including the second foster parent, must complete the training required under subsection (a) of this section within 90 days after the CPA places the child in the care of the foster home.

(c) All caregivers who provide psychotropic medication must finish training for administering psychotropic medication before administering a psychotropic medication.

(d) General caregiver training must include:

(1) topics appropriate to the needs of each child for whom the caregiver will be providing care;

(2) trauma informed care;

(3) measures to prevent, recognize, and report suspected occurrences of child abuse, including sexual abuse;

(4) procedures to follow in emergencies, such as weather-related emergencies, volatile persons, and severe injury or illness of a child or adult; and

(5) preventing the spread of communicable diseases.

(e) EBI training, safe sleeping training, and psychotropic medication training must include curriculum determined by the CPA.

(f) The CPA may decide not to require a foster parent to take EBI training if the CPA determines the training does not directly apply to the:

(1) ages of each child in care, and

(2) types of services the home will provide.

§749.805. Pediatric First Aid and Pediatric Cardiopulmonary Resuscitation (CPR) Requirements.

(a) One foster parent must be certified in pediatric first aid and pediatric CPR before a child-placing agency (CPA) issues the foster home verification. Other caregivers, including a second foster parent, must be certified in pediatric first aid and CPR within 90 days after the CPA verifies the home.

(b) Pediatric first aid must include training related to rescue breathing and choking.

§749.807. Additional Caregiver Training Requirements.

(a) From the date a child-placing agency (CPA) verifies a foster home (home), the CPA must annually evaluate the home to identify any areas of non-compliance with minimum standards. The CPA will evaluate the following:

(1) immediate needs of the household;

(2) compliance history of the home; and

(3) investigation history of the home.

(b) If the CPA identifies areas of non-compliance in the home, the CPA must provide all caregivers in that home with additional training appropriate to address the areas of non-compliance.

(c) For each home that provides care to a child receiving treatment services for emotional disorders, intellectual disabilities, or autism spectrum disorder, the CPA must provide at least one hour of annual training to each caregiver relating to the treatment services the child in care receives, regardless of whether the CPA identifies concerns in the home.

(d) Except for the training required in subsection (c) of this section, the CPA may decide not to require the additional training for all caregivers if no concerns are found during the annual check.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600396

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 2. EMPLOYEE TRAINING REQUIREMENTS

26 TAC §§749.821, 749.823, 749.825

STATUTORY AUTHORITY

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.821. Employee Orientation Requirements.

Before beginning work in a child-placing agency each employee must go through an orientation that includes:

(1) an overview of the relevant and applicable laws and rules of this chapter;

(2) information about how the CPA is organized, its rules, and the services and programs it offers; and

(3) the needs and characteristics of each child in care that the CPA is licensed to serve.

§749.823. New Employee Training Requirements.

(a) Within 30 days after starting the job, child-placing agency administrators, treatment directors, child placement staff, child placement management staff, and full-time professional service providers must complete:

(1) at least two hours of training that addresses normalcy, trauma informed care, and preventing the spread of communicable diseases; and

(2) emergency behavior intervention (EBI) training, consistent with the child-placing agency's EBI curriculum.

(b) An employee who only handles adoption services responsibilities does not have to complete any new employee training.

(c) An employee who only handles responsibilities for a child in care receiving treatment services for primary medical needs does not have to complete EBI training.

(d) Before acting as a caregiver, an employee must have pediatric first aid and pediatric cardiopulmonary resuscitation training.

§749.825. Employee Annual Training Requirements.

(a) Each child placement staff, child placement management staff, executive director, treatment director, and child-placing agency (CPA) administrator must complete at least 15 hours of annual training.

(b) At least one hour of the training must be about preventing, recognizing, and reporting child abuse, neglect, and exploitation, specifically:

(1) the factors indicating a child is at risk for abuse, neglect, or exploitation;

(2) the warning signs indicating a child may be a victim of abuse, neglect, or exploitation;

(3) the procedures for reporting child abuse, neglect, or exploitation; and

(4) a list of community organizations that have training programs on preventing, recognizing, and reporting child abuse, neglect, and exploitation that are available to CPA staff members, each child in care, and parents.

(c) A CPA must have a clear way to track annual training, based on either the hire date, calendar year, or fiscal year, and use this method consistently.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600397

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 3. EMPLOYEE AND CAREGIVER TRAINING DOCUMENTATION REQUIREMENTS

26 TAC §749.831

STATUTORY AUTHORITY

The new section is authorized by Texas Government Code §542.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services agencies, and Texas Government Code §524.0005, which provides the executive commissioner of HHSC with broad rulemaking authority. In addition, HRC §42.042(a) requires HHSC to adopt rules to carry out the requirements of Texas Human Resources Code Chapter 42.

The new section affects Texas Government Code §524.0151 and HRC §42.042.

§749.831. Employee and Caregiver Documentation of Required Trainings.

(a) A child-placing agency (CPA) must check that all training teaches job-related skills. The CPA must document how the CPA determined the training met this requirement.

(b) A test must be given at the end of every training that shows the caregiver's or employee's understanding of how to apply the skills in the foster home or work environment. The test must be signed and dated by the caregiver or employee.

(c) The CPA must document and maintain proof in the caregiver's or employee's record that the caregiver or employee completed the following training:

(1) for all caregivers:

(A) pre-verification training;

(B) caregiver training;

(D) additional training topics covered, including:

(i) the results of the annual evaluation for concerns about health, safety, and well-being of each child in care; and

(ii) if the CPA determines that a foster home requires additional training to address areas of non-compliance identified during the CPA's annual evaluation of the foster home, an explanation of how the CPA chose the training topics for each caregiver's additional training; or

(iii) when the CPA does not find any areas of non-compliance, the reasoning the CPA used for each caregiver for not requiring annual training for each caregiver; and

(2) for all employees:

(A) orientation;

(B) new employee training;

(D) annual training, including a statement signed by the employee that the abuse, neglect, and exploitation training requirements were met.

(d) If the CPA determines that a caregiver is not required to complete an annual training not required by statute, the CPA must document the reason the training was not required.

(e) Certificates for pediatric first aid and pediatric cardiopulmonary resuscitation must have an expiration date, and the training documented on the certificate must be renewed before the expiration date.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600398

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

SUBCHAPTER G. FOSTER HOME SCREENINGS AND VERIFICATIONS

DIVISION 1. FOSTER HOME SCREENINGS

26 TAC §§749.901, 749.903, 749.905

STATUTORY AUTHORITY

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.901. Foster Home Screenings.

(a) A child-placing agency (CPA) must complete a foster home (home) screening as detailed in this section before verifying a home.

(b) The CPA must update the home screening with an addendum any time there is a major life change in the foster family or a change that affects the home's verification.

(c) Through interviewing each prospective foster parent or completing a joint interview, the CPA must obtain, discuss, assess, and document the following information about a prospective home.

(1) The age of each prospective foster parent and any other member of the household.

(2) The basic competency of each prospective foster parent, including ensuring and documenting that each prospective foster parent:

(A) can meet basic competencies, including basic reading, writing, and math; or

(B) have a support system in place that can immediately assist with these competencies.

(3) The personal characteristics of the prospective foster parents, including an assessment of each parent's:

(A) emotional stability, character, health, and ability to manage adult responsibility;

(B) motivation and willingness to provide foster care, including the parents' expectations for the child in care and willingness to adjust those expectations based on the needs of the child in care; and

(4) History of current interpersonal relationships, including marriages, common-law marriages, and other relationships between people who share or have shared a domestic life without being married, and family relationships, including:

(A) the current relationship status and quality of the relationship between the prospective foster parents; and

(B) the quality of the relationship between the prospective foster parents and the prospective foster parents' children living in or out of the home, including:

(i) strengths and problems in all relationships; and

(ii) how the strengths and problems may impact a child placed in the care of the home.

(5) The financial status of the prospective foster parents, including:

(A) discussing with the prospective foster parents the current reimbursement process, if applicable, and ensuring the prospective foster parents' understanding of that process; and

(B) the CPA's determination that the prospective foster parents have or have reasonable access to sufficient resources to support the household and all children in care.

(6) The results of criminal history and central registry background checks conducted on the prospective foster parents and on any non-client 14 years old or older who regularly or frequently stays at or is present in the home, including:

(A) confirmation that the required Child Care Regulation (CCR) background checks were conducted and assessed on:

(i) each prospective foster parent; and

(ii) any non-client who is at least 14 years old or older who will be regularly or frequently staying at or is present in the home, excluding children or young adults in care;

(B) documentation the CPA assessed all background check results received from CCR and any background check information self-disclosed by the prospective foster parents and any person connected to the home;

(C) documentation, including the background check Eligibility Determination provided by the Texas Health and Human Services Commission; and

(D) the CPA must not include any background check results received from CCR in the home screening document.

(7) A history of the prospective foster parents' residence, including the length of time spent at each residence for the last two years. The history must include each full street address, and the CPA must:

(A) ask the prospective foster parents if the police have come to any of the homes in the past two years;

(i) if the police have come to any of the prospective foster parents' homes, obtain service call information from the appropriate law enforcement agency for each of the prospective foster parents' addresses over the past two years; and

(ii) regardless of background check results, if the prospective foster parents report any incident requiring the police to come to any of the homes, request background information from each law enforcement agency that responded, and discuss the incident and any additional background information that the CPA obtains with the prospective foster parents; and

(B) report to CCR the information obtained about the prospective foster family's domestic violence history, as applicable. The CPA must report this information regardless of whether the CPA verifies the home. This report must be made to CCR within two days of learning about the history.

(8) Health status of all persons living in the home, including:

(A) information about the current and previous physical and mental health status (including substance abuse history) of all persons living in the home in relation to the family's ability to provide foster care; and

(B) whether any noted health-related issue may affect the prospective foster parents' ability to care for a child placed in the care of the home.

(9) The prospective foster parents' values, feelings, and practices regarding child-care and discipline, including:

(A) each prospective foster parent's experience caring for children;

(B) the ways each prospective foster parent was disciplined as a child and the prospective foster parent's reactions to the discipline;

(C) each prospective foster parent's discipline styles, techniques, and ability to recognize and respect differences in children and use discipline methods suitable to an individual child; and

(D) the CPA's approved disciplinary methods, and if a prospective foster parent's current discipline methods are different from those the CPA approves the CPA must discuss and assess how the foster parent would change child care discipline practices to conform to the CPA's approved methods.

(10) Each prospective foster parent's sensitivity to and feelings about a child in care who may have been subjected to abuse, neglect, or exploitation, including each prospective foster parent's:

(A) understanding of the dynamics of child abuse, neglect, and exploitation;

(B) understanding and methods of dealing with the prospective foster parents' own past experiences of abuse and neglect, if the prospective foster parents have any; and

(C) understanding of how these issues and experiences may affect the prospective foster parents, other family members of the prospective foster parents, and a child in care.

(11) The attitude of other household members about the prospective foster parents' plan to provide foster care, including each household member's:

(A) involvement in the care of a child in care;

(B) attitudes toward a child in care; and

(12) Support systems available to each prospective foster parent, and support the family may receive from these resources, including information about any person who may provide support as a caregiver during an unexpected event or crisis, such as an illness or disability of a kinship parent, loss of transportation, or death of an immediate family member.

(13) Prospective foster parent's ability to work with specific kinds of behaviors and backgrounds, including each prospective foster parent's:

(A) willingness and ability to:

(i) work with children who have challenging behaviors;

(ii) care for children of a specific sex and age range;

(iii) care for a specific number of children, including children who are part of the same sibling group; and

(iv) provide additional services, such as respite care; and

(B) understanding of the:

(i) concepts of trauma informed care and how to use those concepts in the care, treatment, and management of a child placed in the home; and

(ii) dynamics of separation and loss and the effects of these experiences on a child.

(14) Obtain and assess background information from all other CPAs that have previously verified the home and document the reason the home was closed. Before approving and verifying the home, the receiving CPA must address the closure or any identified risk indicators, as applicable, with the prospective foster parents before approval and verification of the home if the background information indicates the home:

(A) was closed by the previous CPA;

(B) had potential risk indicators that the previous CPA did not adequately address; or

§749.903. Required Interviews and Reference Checks.

(a) Interviews and reference checks for a foster home (home) screening must include:

(1) one individual interview with each prospective foster parent and each household member at least three years old or older living in the home either full or part time;

(2) one joint interview with the prospective foster parents;

(3) one in-home family group interview with all household members present;

(4) one individual interview with each adult child of the prospective foster parents not living in the home; and

(5) three additional references, including at least one from a non-relative.

(b) For subsection (a)(4) of this section, if the child-placing agency (CPA) cannot reach an adult child, the CPA may skip the interview once the CPA has tried to contact the individual at least three separate times.

§749.905. Home Screening Documentation Requirements.

A child-placing agency must maintain the following documentation in the foster home (home) record:

(1) a dated copy of the home screening that includes:

(A) documentation of interviews and reference checks, including all interview attempts and outcomes;

(B) addendums to the home screening, including the date the addendum was completed, and

(2) changing conditions of the verification for an existing home, including review and approval if the home will provide additional services than it was initially verified to offer.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600399

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 2. FOSTER HOME VERIFICATION

26 TAC §§749.921, 749.923, 749.925, 749.927, 749.929, 749.931, 749.933, 749.935, 749.937

STATUTORY AUTHORITY

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.921. General Requirements.

(a) Each foster parent must be at least 18 years old.

(b) A child-placing agency (CPA) may verify only one spouse as a foster parent if:

(1) the spouse whom the CPA verifies will be the only one responsible for the day-to-day care of a child in care in the foster home (home); and

(2) the CPA determines that the spouses maintain separate residences.

(c) A home may not be verified to provide foster care services by more than one CPA at a time; however, a home may be verified by one agency to provide foster care services and approved by another CPA for adoption only.

§749.923. Verifying a Foster Home.

(a) A child-placing agency (CPA) must take the following steps to verify a foster home (home).

(1) Complete and document the requirements in this division.

(2) Obtain:

(A) a floor plan, photo, or other documentation of the home that shows the purposes of all rooms in the home and identifies the indoor areas for a child in care use; and

(B) a floor plan or photo of the outside areas that shows the buildings, driveways, fences, storage areas, gardens, recreation areas, and bodies of water.

(3) Evaluate all applicable laws and rules of this chapter by:

(A) completing an inspection of the home to ensure the home meets applicable rules relating to Daily Care, Education, Discipline, and Health and Safety Requirements of this chapter;

(B) making recommendations about the home's overall ability to keep a child in care safe, paying specific attention to areas of substantial safety risk to a child in care and how the CPA addressed areas of identified safety risks with the prospective foster parent before approving and verifying the home; and

(C) documenting in the foster home file the details of the inspection of the foster home, any identified safety risks, and explain how those risks were corrected.

(4) Obtain the review and approval of the home screening, and the recommended verification of the home from the child placement management staff.

(5) Issue a verification certificate that must be posted at the home or be made immediately available for review that includes:

(A) the name and address of the foster family;

(B) the home's total capacity and foster care capacity, including ages and sex of each child in care; and

(b) A new verification certificate must be issued to a home any time there is a change that affects the verification.

§749.925. Temporary Foster Home Verifications.

(a) A child-placing agency (CPA) may issue a temporary foster home (home) verification when a foster family moves from one residence to another.

(b) The temporary verification is valid for a maximum of six months and cannot be extended.

(c) Within 30 days after the foster home moving to the new residence, the CPA must inspect the new residence for compliance with health and safety requirements in this chapter.

(d) Before issuing the non-expiring home verification, the CPA must ensure the home meets all the requirements in this chapter.

(e) The CPA cannot place a new child in the care of the home until the non-expiring verification is issued.

§749.927. Provisional Verifications.

(a) A child-placing agency (CPA) may issue a provisional verification for a foster home (home) when the home transfers from one CPA to another and continues providing care for the children placed there by the previous CPA.

(b) A provisional verification may be used for up to six months from the date the provisional verification was issued and cannot be extended.

(1) the receiving CPA requests and receives the background information from the home's previous CPA;

(2) if the home is moving to a new residence, the receiving CPA inspects the new location and determines that the home meets the health and safety laws and rules in this chapter;

(3) based on the review of the background information and current screening, the receiving CPA decides that the home does not pose a potential risk to the health or safety of a child in care; and

(4) the receiving child placement management staff reviews and approves the provisional verification by signing and dating the provisional verification certificate. The provisional verification certificate must include any conditions or restrictions from the previous verification.

§749.929. Previously Verified Foster Homes.

(a) For a foster home (home) previously verified by another child-placing agency (CPA), the receiving CPA must conduct and complete a new home screening as required in this subchapter.

(b) If a home is transferring from another CPA, the receiving CPA must request information about the home by submitting a written request to the agency that transferred the foster home.

(c) If the home is transferring from another CPA with a child in care, the receiving CPA may verify the home before completion of the background check.

§749.931. Releasing Information About a Previously Verified Foster Home.

(a) A child-placing agency (CPA) must release background information about a current or previous foster home (home) to:

(1) another CPA conducting a home screening, pre-adoptive home screening, or post-placement adoptive report; or

(2) an independent contractor who is hired or required by the court to conduct a social study under Texas Family Code, Chapter 107, Subchapter D.

(b) Background information includes:

(1) the home screening and any related documentation or addendums;

(2) documentation of supervisory visits and evaluations for the past year;

(3) records of deficiencies and resolutions for the past year, including information regarding pending investigations and unresolved deficiencies;

(4) the most current fire and health inspections or checklists;

(5) the transfer or closing summary for the home;

(6) copies of any current or previous plans for to achieve compliance or other type of development plan implemented by Child Care Regulation or the CPA for the past two years, if applicable;

(7) copies of any current or previous corrective action or adverse action plans for the past two years, if applicable; and

(8) information of any pending investigations and any unresolved deficiencies.

(c) A CPA must release the background information to the requesting CPA or independent contractor by the 10th day after receiving the written request, including informing the requesting agency of any pending investigations and unresolved deficiencies. By the 10th day after completion of any pending investigations and unresolved deficiencies, the CPA must release to the requesting agency the:

(1) outcome of any investigations and any resulting deficiencies cited; and

(2) resolution of any deficiencies.

§749.933. Foster Home Verification Changes.

(a) A child-placing agency (CPA) must submit information to Child Care Regulation within two business days after:

(1) verifying a new foster home (home);

(2) temporarily or provisionally verifying a home, including when the verification is no longer temporary or provisional;

(3) placing a home on or removing a home from inactive status;

(4) changing conditions of the verification for an existing home; and

(5) closing a home, including the reason the CPA closed the home.

(b) If a CPA changes the conditions of a home's verification to allow the home to provide additional services, the child placement management staff must ensure there is no conflict of care with a child in care currently in the home.

(1) ensure the individual has completed the necessary background checks; and

(2) evaluate the impact the individual will have on the foster family and each child in care before the individual moves into the home.

§749.935. Foster Homes that Provide Day Care.

A foster home (home) may provide day care in addition to foster care under the following conditions:

(1) the home meets all relevant laws and rules related to the care the home is providing;

(2) the child-placing agency completes a written assessment, signed by child placement management staff, of the:

(A) needs of each child in care of the foster home and how the needs of the children receiving day care services may impact each child receiving foster care services; and

(B) basis for determining no conflict of care exists in providing multiple types of care; and

(3) Residential Child Care Regulation and Child Day Care Programs approve.

§749.937. Transferring or Closing a Foster Home.

(a) A child-placing agency (CPA) must complete a transfer summary or closing summary when a foster home (home) transfers to another CPA or closes.

(b) A transfer summary and a closing summary must include:

(1) a copy of the verification certificate;

(2) the home's addresses for the past two years and, as needed, directions for rural addresses;

(3) the length of time the foster parents have been verified by the CPA;

(4) for each child in care who was in care for the last two years, the:

(A) number of children fostered;

(B) type of treatment services provided to each child in care; and

(5) a description of any limitations on the verification that were in place for the foster home in caring for and working with a child in care;

(6) a description of any risk indicators to a child in care at the time of the transfer or closing;

(7) any plan to achieve compliance or other type of development plan that was in place within the previous 12 months of the date of transfer or closing;

(8) any Texas Health and Human Services Commission Agency Home Closure Recommendation form, corrective action plan, or adverse action plan that was in place at the time of transfer or closing; and

(9) a statement concerning whether the CPA would recommend the home for verification in the future, including whether the CPA would recommend any limitations or restrictions on the verification, and the basis of the CPA's recommendation.

(1) include pending investigations or unresolved deficiencies;

(2) be completed by the 10th day after a CPA receives a written request to transfer and the transferring CPA must forward it immediately to the requesting CPA.

(d) A closing summary must also:

(1) include the reason the home is closing, including whether the CPA required the home to close;

(2) include a description of any pending investigations and unresolved deficiencies; and

(3) be completed by the 20th day after a home is closed.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600400

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 3. CAPACITY AND SUPERVISION

26 TAC §§749.951, 749.953, 749.955, 749.957, 749.959

STATUTORY AUTHORITY

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.951. Capacity and Child/Caregiver Ratio.

(a) A one-parent or two-parent foster home (home) may care for up to six children, with the following guidelines:

(1) if a home cares for infants, the home may care for up to six children with:

(A) a maximum of two infants; and

(B) no more than four children less than six years old.

(2) If a home cares for a child receiving treatment services for primary medical needs requiring total care and has two caregivers (two foster parents or one foster parent and a live-in caregiver), the home may care for up to:

(A) six children, with up to three children who receive treatment services for primary medical needs requiring total care; or

(B) four children if all children receive treatment services for primary medical needs requiring total care.

(3) If the home cares for a child receiving treatment services for primary medical needs requiring total care and has one foster parent, the home may care for up to:

(A) four children, with a maximum of one child who receives treatment services for primary medical needs requiring total care; or

(B) two children, if all children receive treatment services for primary medical needs requiring total care.

(b) The exceptions in subsection (a) of this section do not apply to:

(1) placements that are necessary to maintain a sibling group; or

(2) homes verified to provide treatment services to a child with primary medical needs before January 1, 2015.

(c) The capacity of a foster home includes children in care, as well as adopted and biological children living in the home, children receiving respite services, and children for whom the home provides daycare. Young adults in care also count towards the capacity.

(d) The child-placing agency must check and document in the home record the reason the home can take care of the number of children allowed in the home, including how the CPA considered the following:

(1) number of caregivers;

(2) services being provided and the needs of the children in the home;

(3) developmental age and any medical needs of the children in the home and in placement; and

(4) physical space and bathroom accommodations in the home.

§749.953. Expanding Capacity of a Foster Home.

A foster home may care for seven or eight children as recommended by a child-placing agency (CPA) and approved by Child Care Regulation (CCR). To approve expanding the foster home's capacity, the CPA must:

(1) complete the CCR Foster Family Home Capacity Exception Form; and

(2) request and obtain a variance from CCR.

§749.955. Supervision.

(a) The child placement management staff must ensure that supervision of a child in care adequately accounts for:

(1) the specific needs of the child in care, including any history of high-risk behaviors that would require additional supervision; and

(2) the environment where the supervision is taking place.

(b) A caregiver is responsible for:

(1) knowing which children in care the caregiver is responsible for;

(2) providing the level of supervision necessary to ensure the health, safety and well-being of each child in care, including auditory and/or visual awareness of the ongoing activity of each child in care as appropriate;

(3) being able to intervene when necessary to ensure the safety of each child in care; and

(4) being aware of any special supervision needs based on the developmental age, maturity, and service plan restrictions of the child in care.

(1) where the child in care is scheduled to be and who the child in care will be with; and

(2) how and when the child in care will be returning home.

§749.957. Supervision with Video Cameras.

(a) Video cameras may only be used to supervise, or watch live, a child in care, who is an infant or toddler, unless:

(1) the parents or individual legally allowed to provide permission for the child in care agree to using video cameras; and

(2) the service plan for the child in care notes that using video cameras to help manage risky behaviors or other situations that need extra supervision is acceptable.

(b) If video cameras are allowed:

(1) the video cameras must be placed so that the child in care can have privacy when changing clothes and using the bathroom;

(2) the video cameras may not be used to record the child in care; and

(3) only the foster home's caregivers may have access to view or monitor the video of the child in care.

§749.959. Transitional Living Program Supervision.

Caregivers counted in the child to caregiver ratio and responsible for supervising a child in care in a transitional living program (program) must be:

(1) physically available to each child in care at all times;

(2) capable of responding quickly in an emergency; and

(3) capable of monitoring the ongoing activities of each child in the program.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600401

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 4. BABYSITTING, OVERNIGHT CARE, AND RESPITE CARE

26 TAC §§749.973, 749.975, 749.977

STATUTORY AUTHORITY

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.973. Children in Care as Babysitters.

(a) A child, including a child in care, may serve as a babysitter for another child in the foster home if the child placement management staff approves the child to babysit and establishes limits with duration and frequency.

(b) A child-placing agency must consider:

(1) the developmental age of the child who will provide the babysitting; and

(2) any known history of high-risk behaviors of the child providing the babysitting and the child who will be babysat.

§749.975. Respite Child-Care Services.

(a) Before putting a child in care in respite care, a child-placing agency (CPA) must inform the parent of the child in care and explain the plan for respite care to the child in care, including how long the respite care will last.

(b) The child placement management staff must approve any respite child-care and ensure that the placement will not cause a conflict of care for any child who is already placed in the foster home (home).

(d) After a child in care has been in respite care for 60 days, the CPA must check if the respite care is still the best option and make a plan with a timeframe for when the child in care will go back to the home or move to a new placement.

§749.977. Information Sharing with Babysitter, Overnight Care Provider, or Respite Care Providers.

Before a babysitter, overnight care provider, or respite care provider may provide care to a child in care, a child-placing agency (CPA) must share the following information with the babysitter or provider:

(1) specific needs of the child in care, including:

(A) all psychological, psychiatric, and medical treatments currently provided, including medication and medication instructions, if applicable;

(B) any information needed for the daily care, including supervision, discipline, safety plans, and high-risk behaviors of the child in care; and

(2) emergency contact information for the physician, foster parents, and the CPA of the child in care.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600402

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

SUBCHAPTER H. HEALTH AND SAFETY REQUIREMENTS

DIVISION 1. PHYSICAL ENVIRONMENT SAFETY

26 TAC §§749.1001, 749.1003, 749.1005, 749.1007, 749.1009, 749.1011, 749.1013, 749.1015, 749.1017, 749.1019

STATUTORY AUTHORITY

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1001. Physical Environment of a Foster Home.

(a) The foster home (home) and all structures and equipment on the property's grounds must be kept in a clean, safe, and sanitary condition and be in a reasonable state of repair.

(b) A home must ensure that indoor and outdoor space and equipment do not pose an undue safety risk to children in care.

(c) Caregivers must provide adequate supervision to prevent access to space or equipment that poses a safety risk to a child in care as needed based on the age, maturity, and service plan restrictions of a child in care.

§749.1003. Health Inspections.

(a) A foster home (home) must have either:

(1) a health inspection conducted by the local health authority; or

(2) a health and safety evaluation conducted by the child-placing agency's child placement staff using the Environmental Health Checklist for Foster Homes form.

(b) A home must correct any deficiencies documented during any inspection or evaluation and comply with any conditions or restrictions specified by the inspector or evaluator.

§749.1005. Fire Inspections.

(a) A foster home (home) must have either:

(1) a fire inspection conducted by a state or local fire authority; or

(2) a fire safety evaluation developed and conducted by the child-placing agency's child placement staff.

(b) A home must correct any deficiencies documented during any inspection or evaluation and comply with any conditions or restrictions specified by the inspector or evaluator.

§749.1007. Fire Safety.

(a) A foster home (home) must have a working smoke detector in the following areas:

(1) the kitchen;

(2) hallways or open areas outside of sleeping rooms; and

(3) on each level of a home with multiple levels.

(b) The home must have one non-expired, operational fire extinguisher that is easily accessible in case of emergency.

§749.1009. Emergency Plans.

A foster home must have a written plan for handling potential disasters and emergencies, including fire and severe weather. This plan can be made using a template provided by the child-placing agency (CPA). The CPA that verified the home must annually review and evaluate the plan with all caregivers and children in care. The review of the plan must be provided in the communication method of the child in care.

§749.1011. Animals.

(a) Any animal on the premises of a foster home must not pose an undue health or safety threat to children in care.

(b) Caregivers must provide adequate supervision and intervene as necessary to protect a child in care from any animal-related safety risk based on the animals involved and the age, maturity, and service plan restrictions of a child in care.

§749.1013. Tobacco and E-Cigarette Use.

Household members and visitors are not allowed to smoke tobacco products, cigarettes, e-cigarettes, or vaporizers in front of a child in care or inside the foster home or motor vehicle.

§749.1015. Nutrition and Food Safety.

(a) Caregivers must provide a child in care with food and water that meet the individual needs for growth and diet of the child in care, similar to what other children in the foster home (home) receive.

(b) Caregivers must provide a child in care with drinking water and food that is served in a safe and sanitary manner.

(c) A home must ensure all food items are stored in a manner that protects them from contamination, spoiling, and insects and rodents.

§749.1017. Transportation.

(a) Caregivers must utilize safe and reliable transportation for a child in care.

(b) Special provisions must be made for transporting non-ambulatory and non-mobile children in care. When necessary, this includes locks for wheelchairs and hydraulic lifts.

(c) A caregiver must secure each child in care in an infant safety seat, rear-facing convertible child safety seat, forward-facing child safety seat, child booster seat, safety vest, harness, or a safety belt, as appropriate to the age, height, and weight of the child in care and according to the manufacturer's instructions.

§749.1019. Documentation of Health and Safety Requirements.

A child-placing agency must document the following in the foster home's (home's) record:

(1) the results of each health inspection or health and safety evaluation;

(2) the results of each fire inspection or fire safety evaluation; and

(3) a copy of the home's emergency plan, including any subsequent reviews.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600403

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 2. WEAPONS, FIREARMS, EXPLOSIVE MATERIALS, AND PROJECTILES

26 TAC §§749.1031, 749.1033, 749.1035, 749.1037

STATUTORY AUTHORITY

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1031. Weapons, Firearms, Explosive Materials, and Projectiles in a Foster Home.

(a) Each child-placing agency (CPA) must have and enforce a policy that addresses the presence of weapons, firearms, explosive materials, and projectiles in a foster home. The policy must contain specific requirements to ensure that a child in care does not have unsupervised access to these items, including requiring a foster parent to keep such items in locked storage when they are not in use.

(b) The CPA must determine whether it is appropriate for a specific child in care to use weapons, firearms, explosive materials, or projectiles.

(c) No child in care may use a weapon, firearm, explosive material, or projectile, unless the child in care is directly supervised by an adult knowledgeable about the use of the weapon, firearm, explosive material, or projectile that is to be used by the child in care.

(d) The CPA must determine whether it is appropriate for a specific child in care to use a toy that explodes or shoots.

(e) No child in care may use or be around a toy that explodes or shoots unless:

(1) the CPA determines it is appropriate for the child in care;

(2) the child in care is directly supervised by an adult; and

(3) the toy is age-appropriate for the child in care.

§749.1033. Storage of Weapons, Firearms, Explosive Materials, or Projectiles in a Foster Home.

(a) When determining if weapons, firearms, explosive materials, and projectiles are stored so that a child in care does not have unsupervised access to such items, the child-placing agency (CPA) must consider the age, history, emotional maturity, and background of each child in the care of the foster home (home).

(b) A CPA may not require a home to disclose the specific types of firearms that are stored or otherwise present in the home.

§749.1035. Determining if Weapons, Firearms, Explosive Materials, or Projectiles are Present in a Foster Home.

(a) When a child-placing agency (CPA) completes a foster home (home) screening, the CPA must ask whether weapons, firearms, explosive materials, or projectiles are present in the home. If these items are present, the CPA must review the CPA's weapons, firearms, explosive materials, and projectiles policy and requirements with the prospective foster parents.

(b) The home record must include documentation on:

(1) whether weapons, firearms, explosive materials, or projectiles are present in the home; and

(2) specific precautions the caregivers will take to ensure children in care do not have unsupervised access.

(c) The annual evaluation of the home's compliance with this chapter must include a discussion of whether the home has weapons, firearms, explosive materials, or projectiles, and if so, how these items are stored.

(d) In complying with this rule, a CPA may not require the home to disclose the specific types of firearms that are stored or otherwise present in the foster home.

(e) In complying with this rule, a CPA may not require the home to notify the CPA if there is any change in the types of firearms that are present in the home.

§749.1037. Transporting a Child in Care in a Vehicle Where Weapons, Firearms, Explosive Materials, or Projectiles are Present.

(a) A caregiver may transport a child in care in a vehicle where firearms (other than handguns), other weapons, explosive materials, or projectiles, are present if:

(1) all firearms are not loaded;

(2) the firearms, other weapons, explosive materials, or projectiles are inaccessible to the child in care; and

(3) possession of the firearm is legal.

(b) A caregiver may transport a child in care in a vehicle where a handgun is present if:

(1) the handgun is in the possession and control of the caregiver; and

(2) the caregiver is not prohibited by law from carrying a handgun.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600404

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 3. SLEEPING SPACE AND BATHROOM REQUIREMENTS

26 TAC §749.1051, §749.1053

STATUTORY AUTHORITY

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1051. Indoor Space: Sleeping Spaces and Sleeping Surfaces.

(a) Each child in care must have a designated sleeping space with an individual sleeping surface, such as a bed or mattress, and linens. Up to four children may share a sleeping space with approval from the child placement management staff (CPMS).

(b) Sleeping spaces and surfaces must fit the needs, developmental level, and age of the child in care.

(c) Before approving a child in care to share a sleeping space or sleeping surface, the CPMS must determine and document in the service plan of the child in care there is no known risk of harm to the child in care by sharing a sleeping space or sleeping surface with the other individual after assessing:

(1) the relationship between the child in care and the individual;

(2) the ages and developmental levels of the child in care and the individual, noting that after the 18th birthday of the child in care, the child in care may share a bedroom with another youth who is 16 years old or older, provided the age difference does not exceed two years;

(3) the behaviors of the child in care and the individual;

(4) any history of possible sexual trauma or sexually inappropriate behaviors of the child in care or the individual; and

(5) any other identifiable factors that may affect the appropriateness of the individual and the child in care sharing a sleeping space.

(d) CPMS may not approve an infant to share a sleeping surface.

§749.1053. Indoor Space: Bathrooms.

A foster home must have at least:

(1) one bathroom that allows for privacy;

(2) one toilet; and

(3) one bathroom sink and one tub or shower that have hot and cold running water.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600405

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 4. POOLS AND WATER ACTIVITIES

26 TAC §§749.1061, 749.1063, 749.1065

STATUTORY AUTHORITY

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1061. Water Safety: Pools, Hot Tubs, and Bodies of Water.

(a) Swimming pools must have a barrier on all sides, at least four feet high. An exterior wall of the home may serve as one side of the barrier.

(b) Gates or other means of access to a pool or hot tub must be secured with a safety device, such as a bolt lock, which is locked when the pool or hot tub is not in use.

(d) Any door that leads from the home to an area with a swimming pool, hot tub, or body of water must have:

(1) a door alarm; or

(2) a lock that is only accessible and operational by an adult unless:

(A) the state or local fire authority determines that the lock violates the fire code; and

(B) the child-placing agency keeps the fire authority's determination in the foster home record.

(e) The bottom of a swimming pool or hot tub must always be visible.

(f) Swimming pool and hot tub chemicals and machinery rooms must be inaccessible to children in care.

§749.1063. Swimming Supervision.

(a) Caregivers must inform each child in care about house rules for the use of a swimming pool, hot tub, or other body of water and appropriate safety precautions.

(b) Supervision and monitoring of safety features must be adequate to protect any child in care from unsupervised access to the swimming pool, hot tub, or other body of water.

(c) Caregivers must ensure that a child in care has access to a lifesaving device when using a swimming pool, hot tub, or body of water.

(d) A child in care participating in a swimming activity who is unable to swim must wear a personal flotation device (PFD). A PFD is a vest or suit designed to keep the wearer afloat in water and prevent drowning. The PFD must be:

(1) United States Coast Guard-approved with a rating of Type I, II, or III, or a buoyancy level of 70 or above; and

(2) properly fitted and fastened for the child.

(e) Caregivers must assess the swimming skills of a child in care before allowing the child in care into the swimming pool, hot tub, or any other body of water. The child-placing agency must document how the caregiver checked the swimming skills and keep this information in the record of the child in care.

(f) When watching a child in care in a swimming pool, hot tub, or any other body of water, caregivers must stay close by and pay attention to the child in care at all times. The caregiver must be able to see and hear the child in care and be ready to help in case of an emergency.

(g) Caregivers must be able to clearly see all parts of the swimming pool or hot tub when supervising activity in the area.

§749.1065. Swimming Ratios.

(a) There must be one caregiver to supervise each child under the age of two during swimming activities.

(b) If four or more children over the age of two participating in swimming activities, there must be at least two caregivers present supervising the activity area.

(c) There must be one caregiver to supervise each child who is non-ambulatory or who is subject to seizures during swimming activities. Caregivers do not need to meet this requirement if a licensed physician determines special precautions are not needed and documentation of the determination is maintained in the child in care's file.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600406

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

SUBCHAPTER I. FOSTER HOME MANAGEMENT AND EVALUATION

26 TAC §§749.1101, 749.1103, 749.1105, 749.1107, 749.1109

STATUTORY AUTHORITY

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1101. Foster Home Verification Change Management.

(a) A child-placing agency (CPA) must monitor a foster home (home) for changes that invalidate the home's verification.

(b) If something happens that makes a home's verification invalid, a new or temporary verification must be given after the CPA checks that the home follows the laws and rules in this chapter.

(1) marriage, divorce, separation, death, birth, or any other change in household composition;

(2) changes in the home's address or location;

(3) changes in the number of children a home may have in care;

(4) changes in the ages or sex of children for whom the home is authorized to provide care; and

(5) changes in the types of services the home will provide.

§749.1103. Foster Home Compliance Evaluation.

(a) A child-placing agency (CPA) must check each year to ensure a foster home (home) is following all the laws and rules that apply to the home.

(b) The CPA must evaluate a home's compliance with relevant laws and rules each time:

(1) there is an allegation of a deficiency in the home;

(2) there is a major life change in the home that invalidates the verification; or

(3) the CPA receives a report of family violence at the home from the Texas Department of Family and Protective Services.

(1) develop a plan to achieve compliance that includes:

(A) a list of all the actions or changes the home needs to make to correct deficiencies, including:

(i) how much time the home has to correct the deficiencies; and

(ii) what will happen if the deficiencies are not corrected; and

(B) a decision about whether a child in care may stay in the home and if the home may accept a new child into care before the deficiencies are corrected; and

(2) ensure the home corrects any deficiencies by either inspecting the home again or obtaining proof that issues are corrected.

§749.1105. Foster Home Supervisory Visits.

(a) Child placing staff must visit the foster home (home) at least every three months for supervisory visits.

(b) The supervisory visits must happen inside the home.

(1) two of the visits must be unannounced;

(2) one visit must have all household members present; and

(3) both foster parents, if there are two, must be present for one visit every six months.

(d) At least once every three months the supervisory visit must evaluate any:

(1) changes to household members, frequent visitors, or persons who will provide support as a caregiver during an unexpected event or crisis; and

(2) changes to the home that have an impact on the health, safety, or well-being of a child in care as determined by the child-placing agency.

§749.1107. Inactive Foster Homes.

(a) A child-placing agency (CPA) may place a foster home (home) on inactive status if the CPA makes sure there are no children in care. Inactive status cannot be used instead of closing the home if there are ongoing concerns that could harm the health or safety of a child in care.

(b) If the CPA puts a home on inactive status or takes the home off inactive status, the CPA must inform Child Care Regulation by submitting an Agency Home Report Form.

(d) If a home wants to have active status again and care for a child, the CPA must make a supervisory visit to the home to ensure it meets the laws and rules in this chapter before a child can be placed in the home.

(e) Background checks are not required for a home that is on inactive status. If the home returns to active status, the background checks must be active and in an Eligible or Conditional status before a child can be placed in the home.

§749.1109. Ongoing Monitoring Documentation Requirements.

A child-placing agency (CPA) must document and maintain the following information in the foster home's record.

(1) When checking the foster home (home) for compliance or completing a supervisory visit:

(A) the date the evaluation or supervisory visit was completed and the household members present;

(B) a summary of the topics talked about, which rules were checked, and any deficiencies found, signed by each foster parent present;

(D) a follow-up plan including proof that all deficiencies have been corrected.

(2) For a home on inactive status:

(A) the agreement between the CPA and foster parents that the home will be placed on inactive status and will not accept placement; and

(B) when a home on inactive status wishes to return to active status, the CPA must check and ensure that the home is following all laws and rules in this chapter and has done the necessary background checks. The CPA must document this before a child can be placed in the home.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600407

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

SUBCHAPTER J. FOSTER CARE SERVICES: MEDICAL AND DENTAL

26 TAC §§749.1201, 749.1203, 749.1205, 749.1207, 749.1209, 749.1211, 749.1213, 749.1215, 749.1217

STATUTORY AUTHORITY

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1201. Admission Criteria.

(a) A child-placing agency (CPA) may admit a child or young adult for placement in a foster home (home) after ensuring:

(1) the child or young adult meets the CPA's admission policy;

(2) the CPA and foster home can provide the services the child or young adult requires; and

(3) the home can meet the child or young adult's specific needs.

(b) The CPA may admit a young adult into the care of a home if the young adult:

(1) comes immediately from another residential child-care operation;

(2) will continue to need the same level of care and is unlikely to physically or intellectually progress over time; and

(3) is in the care of the Texas Department of Family and Protective Services.

(c) A child, at least 14 years old, or young adult may be admitted to a CPA's transitional living program as a non-emergency admission.

§749.1203. Initial Requirements at the Time of Admission or Verification.

(a) For each child in care living in the foster home (home) at the time of verification or who is subsequently placed in the home, a child-placing agency (CPA) must obtain the following information, if available, before verifying the home or admitting the child into care:

(1) the child's name, and date of birth;

(2) a brief description of the circumstance that led to the reason the child needs a placement and the reason the last placement ended;

(3) the child's current health status, chronic or acute health conditions, such as asthma, diabetes, special dietary needs, allergies, and medications the child is taking, including possible side effects;

(4) identification of the child's immediate treatment and educational needs;

(5) identification and assessment of any of the child's high-risk behaviors, the results of the suicide risk screening, and supervision needs; and

(6) known contraindication to the use of restraint.

(b) The CPA must provide prospective caregivers with the child's initial admission information within 24 hours after the date of admission.

§749.1205. Admission Assessment.

(a) A child-placing agency (CPA) must complete the admission assessment within 15 days after the date of admission. The admission assessment for a child in care must include:

(1) legal status, and the circumstances that led to the referral for foster care;

(2) all history of abuse, neglect, or exploitation and history of trauma;

(3) current medical status, including the:

(A) results of the most recent medical and dental examinations;

(B) all medical diagnoses requiring treatment services; and

(4) mental and behavioral health history, including substance use history;

(5) developmental and educational history;

(6) social history, including the home environment, the quality of family relationships, family functioning, and religion;

(7) criminal history, if applicable; and

(8) documentation of how the CPA can meet the needs and behaviors of the child in care, and the services the CPA plans to provide to the child in care.

(b) If a child in care receives treatment services for primary medical needs, the admission assessment must also include:

(1) confirmation that the child in care can live safely in a foster home setting and that the foster parents have the skills to meet the needs of the child in care; and

(2) all physician orders related to the child in care.

(c) The admission assessment must be given to the caregivers and professional service providers who are working with the child in care within five days after the assessment is finished.

§749.1207. Admission Orientation Requirements.

(a) Within seven days after the date of admission, a child-placing agency (CPA) must provide an orientation to each child in care who is at least five years old or older. The orientation must be easy for the child in care to understand, in the main language and communication method of the child in care, and suitable for the age of the child in care.

(b) Orientation must include information about the CPA's child-care policies.

§749.1209. Placement Agreement.

(a) A placement agreement is a child-placing agency's (CPA's) agreement with the foster child's parent or the foster child that defines the CPA's roles and responsibilities and authorizes the CPA to obtain or provide services for the foster child. A CPA placement agreement must include:

(1) authorization from the parent permitting the CPA to care for the child in care;

(2) the reason for placement and anticipated length of time in care; and

(3) a medical consent form signed by the parent.

(b) For a transitional living program, a child 16 years old or older in care may sign the placement agreement without parental consent if the child in care:

(1) resides separately from the parent, independently manages the financial affairs of the child in care, is unmarried and pregnant, or a parent; and

(2) the CPA attempts to notify the parent of the child in care of the location of the child in care.

§749.1211. Pre-Placement Requirements.

(a) Before placement, child placement staff must:

(1) ensure the placement is suitable for the needs and behaviors of the child in care by using the initial admission information and the home study for the foster home; and

(2) talk to the child in care about why the child in care is being placed and confirm the understanding and response of the child in care.

(b) For non-emergency placements, a child at least six months of age or older in care must visit the foster home at least once before placement.

(c) During the pre-placement visit, child placement staff must observe the interaction between the child in care and household members.

(d) There must be time between the pre-placement visit and placement to allow the child in care and foster parents to each meet privately with child placement staff to discuss and consider placement.

§749.1213. Post-Placement Contacts.

(a) Child placement staff must have monthly face-to-face contact with each child in care.

(b) Monthly visits must meet the following requirements.

(1) At least half of the contacts must occur in the foster home.

(2) The child placement staff must ensure the child in care is safe and the basic needs of the child in care are being met.

(3) The visits must:

(A) be for a length of time to address the needs and behaviors of a child in care who is verbal, or observe the child in care if they are non-verbal;

(B) provide an opportunity to meet privately; and

§749.1215. Ongoing Placement of Young Adults.

(a) A young adult may remain in care until the young adult is 23 years old to:

(1) attend high school, a program leading to a high school diploma, or GED classes;

(2) transition to independence, including attending college or vocational or technical training;

(3) complete a child-placing agency's program; or

(4) stay with a minor sibling.

(b) A young adult who turns 18 years old while in the care of a foster home may remain in care indefinitely, if the person:

(1) continues to need the same level of care; and

(2) is unlikely to physically or intellectually progress over time.

§749.1217. Admission and Placement Information Documentation.

A child-placing agency (CPA) must document and maintain the following information in the record of the child in care:

(1) the initial admission information obtained, including the date of admission, why any initial admission information could not be obtained, if applicable, and the date the prospective caregiver was provided the information;

(2) admission orientation provided to the child in care, if the child in care is at least five years old or older, including the date the orientation occurred;

(3) the admission assessment, including the date the information was provided to the caregivers and professional service providers working with the child in care;

(4) the signed and dated placement agreement;

(5) attempts to notify a parent of the location of the child in care, if the child in care is signing the placement agreement without parental consent; and

(6) the pre-placement visit and post-placement meeting details, including topics discussed and the dates each visit and meeting occurred.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600408

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

SUBCHAPTER K. SERVICE PLANNING AND DISCHARGE

DIVISION 1. SERVICE PLANNING

26 TAC §§749.1231, 749.1233, 749.1235, 749.1237

STATUTORY AUTHORITY

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1231. General Service Plan Requirements.

(a) A child-placing agency (CPA) must use and follow the most recent service plan for a child in care.

(b) To meet service plan requirements, the CPA must:

(1) use the most recent service plan for the child in care, developed by the agency that referred the child in care for placement, if the plan meets the criteria established in this division; or

(2) complete the initial service plan and service plan reviews using the criteria established in this division.

(d) The CPA must provide the service plan to the child in care, the caregivers for the child in care, and the professionals working with the child in care within five days after the plan is finished.

§749.1233. Initial Service Plan Requirements.

(a) A service planning team must meet to develop an initial service plan for a child in care using the information obtained from the admission assessment.

(b) The initial service plan must identify and address:

(1) medical, dental, dietary, and therapeutic needs, including psychotropic medications;

(2) educational needs, and needs related to intellectual and developmental functioning;

(3) behavioral and supervision needs, including plans to minimize the risk of harm to the child in care or others for a child in care who exhibits high-risk behaviors; and

(4) the trauma of the child in care, including how the child in care copes, and appropriate redirection and discipline methods.

(c) For a child in care receiving any treatment services, the initial service plan must explain why the child in care needs treatment services and what goals the child in care needs to reach to live in a less restrictive setting.

(d) For a child in care receiving treatment services because of an intellectual disability, the initial service plan must identify and address:

(1) plans to engage the child in care in opportunities for visual, auditory, and tactile stimulation; and

(2) an educational or training plan for normalcy aligned to the functioning of the child in care.

(e) The initial service plan must be finished within 60 days after the child is admitted into care. The plan must include the signatures of the people who helped develop the plan.

(f) The service planning team must check and update the service plan at least every 180 days after the date of the last service plan for the child in care. The review must consider the progress of the child in care, identify any new needs for the child in care, and make a plan to meet these new needs for the child in care.

§749.1235. Service Plan Requirements for Children in Care Receiving Treatment Services.

For a child in care receiving treatment services for emotional disorders, autism spectrum disorder, or intellectual disabilities, the child-placing agency must obtain a written, dated, and signed psychosocial assessment, or equivalent assessment or evaluation, completed within:

(1) 14 months after the date of admission, if the child in care is coming from another regulated residential child-care operation; or

(2) six months after the date of admission if the child in care is not coming from another regulated residential child-care operation.

§749.1237. Service Plan Documentation Requirements.

A child-placing agency must maintain the following documentation in the record of a child in care:

(1) the initial service plan or most recent service plan developed by the agency that referred the child for placement; and

(2) the psychosocial assessment or equivalent assessment or evaluation, if applicable.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600409

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 2. DISCHARGE AND TRANSFER PLANNING

26 TAC §749.1251, §749.1253

STATUTORY AUTHORITY

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1251. Discharge and Transfer Requirements.

(a) The child-placing agency (CPA) must:

(1) have at least one person from the service planning team for a child in care help with planning the discharge or transfer for the child in care;

(2) consult with the service planning team about whether the child in care should be told in advance about the discharge or transfer and follow the team's recommendations; and

(3) If the service planning team decides the child in care should be told in advance about the discharge or transfer, the child in care must be informed at least four days before the date of discharge or transfer.

(b) The CPA may discharge a child in care to:

(1) the parent of the child in care;

(2) anyone with written authorization from the parent; or

(3) a person authorized by a court or by law to assume custody of the child in care.

(1) ensure one of the caregivers for the child in care or child placement staff goes with the child in care to the new placement unless the parent of the child in care or law enforcement is transporting the child in care;

(2) provide the prescribed medications for the child in care to the person the child in care is discharged or transferred to; and

(3) provide the belongings of the child in care to the child, the parent of the child in care, or the person the child in care is discharged or transferred to.

(d) The CPA must provide a discharge or transfer summary to the receiving placement or caregiver within 15 days after the child in care is discharged or transferred, which includes:

(1) a summary of:

(A) services provided to the child in care;

(B) an assessment of the current behaviors and needs of the child in care, and recommended services to meet those needs;

(D) identified resources to support the child in care with the transition, including contact information; and

(2) The background information of the child in care, including unresolved incidents or investigations, and previous assessments and evaluations performed.

§749.1253. Discharge and Transfer Documentation Requirements.

A child-placing agency (CPA) must document and maintain the following information in the record of the child in care:

(1) the response of the child in care to the discharge or transfer;

(2) if the child in care was not told about the discharge or transfer, an explanation of why the child in care was not told; and

(3) the written discharge or transfer summary, including the date it was provided to the receiving placement or caregiver.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600410

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

SUBCHAPTER L. FOSTER CARE SERVICES: EMERGENCY BEHAVIOR INTERVENTION

26 TAC §§749.1301, 749.1303, 749.1305, 749.1307

STATUTORY AUTHORITY

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1301. Child-Placing Agency Responsibilities Related to Child Rights.

(a) A child-placing agency (CPA) must protect the rights of a child in care and ensure caregivers and adoptive parents do not take away or limit the child's rights while the child is in care.

(b) The CPA is responsible for removing the child in care from a situation where abuse, neglect, or exploitation exists.

(c) The CPA must review the child's rights with the child in care and the parent of the child in care unless the parent's consent is not required. The CPA must also provide the child in care and the parent of the child in care a written copy of the child's rights.

(d) Child rights must be:

(1) written in plain language; and

(2) given in a way that is easy for the individual to understand.

§749.1303. Child Rights.

The rights of a child in care include any other rights given by law or other Child Care Regulation rules. A child-placing agency (CPA) must follow the child's rights, which include the following.

(1) Safety and care.

(A) The right to care and treatment that meets the needs of the child in care in the most family-like setting possible.

(B) The right to be free from abuse, neglect, and exploitation.

(2) Family contacts. The right to maintain regular contact with the parents, siblings, and other extended family of the child in care, unless restrictions are necessary to protect the health, safety, or well-being of the child in care, as determined by the service plan or a court order.

(3) Living a normal life.

(A) The right to communicate in the way the child in care prefers. The CPA must make every reasonable effort to place the child in the care of foster parents who can communicate with the child.

(B) The right to receive educational services appropriate to the age and developmental level of the child in care.

(D) The right to participate in childhood activities, including those with the foster family and other activities outside the home, suitable for the age and development of the child in care.

(E) The right to privacy, which includes sending and receiving unopened mail, making and receiving phone calls, keeping a personal journal, and having visitors, unless it is necessary to limit these activities to keep the health, safety, or well-being of the child in care protected, as determined by the service plan or a court order.

(F) The right to personal care, hygiene, grooming equipment and supplies, and training in how to use them.

(G) The right to have comfortable clothes, including shoes, that fit well and are similar to what other children in the community wear and teenagers should have opportunities to pick out their own clothes.

(H) The right to clothing and shoes that protect the child in care against the weather.

(I) The right to have personal items at the foster home of the child in care and to get additional personal items when needed.

(J) The right to personal space in the sleeping space of the child in care to store clothes and belongings.

(K) The right to be informed of search policies and be free of unreasonable searches and unreasonable removal of personal items.

(L) Depending on the age and maturity of the child in care, the right to seek employment, keep money belonging to the child in care, and have a bank account in the name of the child in care.

(M) The right to consent in writing before taking part in any publicity or fund-raising activity for the home or the CPA, including the use of the photograph of the child in care, and to withdraw the consent.

(N) The right to refuse to make public statements showing gratitude to the home or the CPA.

(O) The right to not be pressured to make a medical decision about a pregnancy, give up a child for adoption, or parent the child, if applicable.

(4) Discipline.

(A) The right to be free from any harsh, cruel, unusual, unnecessary, demeaning, or humiliating treatment or punishment; this means the child in care must not be:

(i) shaken;

(ii) subjected to or threatened with corporal punishment, including spanking or hitting the child in care;

(iii) forced to be outside in excessive heat or cold for excessive periods;

(iv) forced to do unproductive work that serves no purpose except to demean the child in care, such as moving rocks from one pile to another or digging a hole and then filling it in;

(v) denied food, sleep, a bathroom, mail, or family visits as punishment;

(vi) subjected to remarks that belittle or ridicule the child in care or the family of the child in care;

(vii) threatened with the loss of placement or shelter as punishment;

(viii) subjected to demeaning behavior to embarrass, control, harm, intimidate, or isolate the child, "demeaning behavior" may include using physical force, rumors, threats, or inappropriate comments; and

(ix) subjected to emergency behavior intervention, aversive conditioning, or rebirthing, hug, or holding therapy.

(B) The right to discipline that is appropriate to the age, maturity, and developmental level of the child in care.

(C) The right to have restrictions or disciplinary policies explained to the child in care at admittance and when the measures are imposed.

(5) Plans for the child while in care.

(A) The right to have a comprehensive service plan that addresses the needs of the child in care, including transitional and discharge planning.

(B) The right to actively participate in the development of the service plan within the limits of the comprehension of the child in care. The child in care has the right to a copy or summary of the plan. A child 14 years old or older in care has the right to review and sign the service plan.

(6) Medical care and records.

(A) The right to medical, dental, vision, and mental health care and developmental services that adequately meet the needs of the child in care.

(B) The right to request that the care or services be separate from adults (other than young adults in care) who are receiving services.

(D) The right to confidential care and treatment, including keeping medical records and agency records private and only discussing the records when necessary to provide the child with care.

(7) Complaints.

(A) The right to make anonymous calls, reports, or complaints without interference, coercion, punishment, retaliation, or threats of punishment or retaliation.

(B) The child in care has the right to contact:

(i) the Texas Department of Family and Protective Services Abuse/Neglect Hotline;

(ii) the Texas Health and Human Services Commission Ombudsman for Children and Youth in Foster Care;

(iii) the DFPS Office of Consumer Affairs; and

(iv) Disability Rights Texas.

§749.1305. Conducting Searches for Items that Endanger a Child's Safety.

(a) For a child in care, an employee or caregiver may conduct a physical search of the child, the clothing or possessions of a child in care, or the room of a child in care only when there is reasonable suspicion that:

(1) an unlawful or prohibited item is present that endangers the safety of the child in care;

(2) the child in care made suicidal threats or threatened to self-harm or hurt others; or

(3) the child in care is suspected of or was involved in a theft.

(b) If a search of a child in care involves the removal of clothing (other than outer clothing such as coats, jackets, hats, gloves, shoes, or socks):

(1) only a caregiver that is the same sex as the child in care may conduct the search;

(2) there must be an adult witness who is the same sex as the child in care; and

(3) the caregiver must ensure that other children do not witness the search.

(c) With the exception of the mouth of a child in care, a caregiver or employee may not conduct a body cavity search of a child in care.

§749.1307. Child Rights Documentation Requirements.

A child-placing agency (CPA) must document and maintain the following information in the record of the child in care.

(1) A statement signed within seven days after the CPA admits a child into care that each required individual reviewed and understood the child's rights. A signed copy of the "CPS Rights of Children and Youth in Foster Care" meets this requirement.

(2) Plans for contact between the child in care and a parent and the child in care and the siblings of the child in care, including any restrictions the CPA places on the contacts.

(3) When conducting a search that results in the removal of personal items or clothing worn by the child in care the:

(A) name of the child in care, date of the search, and name of the person conducting the search, including any witnesses;

(B) reason for the search and a description of what was searched, including the articles of clothing removed, if applicable; and

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600411

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

SUBCHAPTER M. DAILY CARE, EDUCATION, AND DISCIPLINE

26 TAC §§749.1401, 749.1403, 749.1405, 749.1407, 749.1409, 749.1411, 749.1413, 749.1415, 749.1417, 749.1419, 749.1421, 749.1423

STATUTORY AUTHORITY

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1401. Infants: Basic Care and Supervision.

(a) Each infant in a foster home must receive individual attention, including play, talking, cuddling, and holding.

(b) A caregiver must provide prompt attention to an infant's physical needs, such as feeding and diapering.

(1) keeping the area free of objects that may choke or harm the infant; and

(2) protecting the infant by ensuring electrical outlets have childproof covers or safety outlets.

(d) Items necessary for diaper changing must be kept out of the reach of infants and other children in care.

(e) A caregiver must never leave an infant unsupervised.

(1) a sleeping infant is considered supervised if the caregiver:

(A) is within eyesight or hearing range of the infant and can intervene as needed; or

(B) uses a video camera or audio monitoring device to monitor the infant and is close enough to the infant to intervene as needed.

(2) An awake infant is considered supervised if the caregiver is within eyesight of the infant and is close enough to the infant to intervene as needed. For short periods of time during regular household activities, the infant may be out of the caregiver's sight, as long as:

(A) the infant is within hearing range of the caregiver;

(B) the infant's environment is free of any safety hazards; and

§749.1403. Infants: Cribs.

(a) A foster home (home) that provides care to a child in care who is an infant must have an individual crib for the infant. All cribs must:

(1) have a firm, flat mattress that snugly fits the sides of the crib, and the mattress must not be supplemented with additional foam material or pads and must be waterproof or washable;

(2) have sheets that fit snugly and do not present an entanglement hazard;

(3) be bare, except for a mattress with a tight-fitting sheet, for an infant who is younger than 12 months old; and

(4) be assembled per the manufacturer's instructions with no loose hardware, damaged parts, or entrapment hazards.

(b) A home may use a full-sized, portable, or mesh-side crib if:

(1) the caregivers follow the manufacturer's instructions; and

(2) the crib has mesh that is securely attached to the top of the rails and floor plate, and the folded sides are securely latched in place when raised.

(d) A caregiver must never leave an infant in a crib, portable crib, or mesh-side crib with a side folded down.

(e) An infant receiving treatment services for primary medical needs may have special items that assist with safe sleep at the written recommendation of a health-care professional. The child-placing agency (CPA) must keep the written recommendation in the record of the child in care.

(f) The CPA must notify the parent of each child in care of each home verified by the CPA of any deficiencies relating to subsections (a)(1), (a)(3), (b), or (c) of this section.

§749.1405. Infants: Safe Sleep Requirements.

(a) A caregiver must place an infant who is unable to turn over without assistance in a face-up sleep position unless a health-care professional orders otherwise. A child-placing agency (CPA) must keep any orders from a health-care professional in the record of the child in care.

(b) An infant's head, face, or crib must not be covered at any time by any item, including a blanket, linen, or clothing.

(d) An infant must not sleep in a restrictive device, such as a car seat, swing, bouncy seat, or highchair. If an infant falls asleep in one of these devices, the caregiver must move the infant to a crib as soon as possible.

(e) An infant who can roll over without assistance must not be swaddled.

(f) The CPA must notify the parent of each child of each foster home verified by the CPA of any deficiencies cited in this section.

§749.1407. Infants: Equipment Safety.

(a) A highchair, swing, stroller, infant carrier, rocker, bouncer seat, or similar item that a foster home (home) uses for an infant must have safety straps fastened when the equipment is in use with the infant. The caregivers must follow the manufacturer's instructions.

(b) A home may not use any of the following types of equipment for infants:

(1) baby walkers;

(2) baby bungee jumpers; and

(3) accordion safety gates.

§749.1409. Infants: Feeding Requirements.

(a) Caregivers must feed an infant based on the recommendations of the infant's health-care professional.

(b) Unless recommendations from the health-care professional are contrary, caregivers must hold the infant while feeding the infant if the infant is:

(1) birth through six months old; or

(2) unable to sit unassisted in a highchair or other seating equipment during feeding.

(d) A caregiver who cares for more than one infant must:

(1) sterilize shared bottles or training cups between uses by different infants; and

(2) clean highchair trays before each use.

§749.1411. Toddlers: Basic Care Requirements.

(a) Each toddler must receive individual attention, including play, talking, and cuddling.

(b) A caregiver must ensure that the environment is safe for each toddler, including:

(1) keeping the area free of objects that may choke or harm the toddler; and

(2) protecting the toddler from dangerous items or areas, such as ensuring each accessible electrical outlet has a childproof cover or safety outlet.

(1) is within eyesight or hearing range of the toddler and can intervene as needed; or

(2) uses a video camera or an audio monitoring device to monitor the toddler and is close enough to the toddler to intervene as needed.

§749.1413. Additional Requirements for Pregnant Children in Care.

For a pregnant child in care, a child-placing agency must:

(1) ensure information, training, and counseling is available about pregnancy, prenatal care, childbirth, and recovery from childbirth; and

(2) inform the child in care, within seven days after the date of admission or on learning about the pregnancy, of the right not to be pressured to make a medical decision about the pregnancy, give up the child for adoption or parent the child.

§749.1415. Additional Requirements for Children in Care Receiving Treatment Services for Primary Medical Needs or Intellectual Disabilities.

(a) A caregiver who cares for a child in care receiving treatment services for primary medical needs or an intellectual disability must follow recommendations from the medical providers for the child in care, including recommendations relating to physical and sensory stimulation.

(b) A caregiver must ensure a child in care receiving treatment services for primary medical needs or an intellectual disability has opportunities for physical and sensory stimulation.

§749.1417. Discipline and Punishment.

(a) Only a caregiver known to and knowledgeable of a child in care may discipline the child.

(b) All disciplinary measures used with a child in care must be consistent with the child's rights related to discipline and punishment in this chapter.

§749.1419. Normalcy and Reasonable and Prudent Parent Requirements.

A foster parent must ensure a child in care has the opportunity to participate in childhood activities, including unsupervised activities, using the reasonable and prudent parent standard. For a child in care, the foster parent must consider the:

(1) age, level of maturity, overall abilities and developmental level, and desires; and

(2) behavioral history and ability to safely participate in a proposed activity considering the surrounding circumstances, hazards, risks, and supervision of the activity.

§749.1421. Educational Services: General.

A child-placing agency (CPA) must arrange appropriate education for each child in care, including:

(1) ensuring each child in care attends an educational facility or program that is accredited or otherwise recognized by state law and is the least restrictive educational setting to meet the needs and abilities of the child in care;

(2) advocating for the child in care to receive educational and related services to which the child in care is entitled under provisions of federal and state law and regulations, including the implementation of an Individual Education Plan (IEP) for students receiving special education services;

(3) ensuring that the education program is appropriate to the intellectual and social functioning of the child in care and encourages normalization through appropriate stimulation and by encouraging self-help skills; and

(4) designating a liaison between the CPA and the school of the child in care.

§749.1423. Educational Services: Caregiver Responsibilities.

Caregivers must:

(1) know how the child in care is doing in school by looking at the report cards and other information about the child in care from the school;

(2) request Admission, Review, and Dismissal (ARD), Individual Education Plan (IEP), and Individual Transitional Planning (ITP) meetings, if concerned with an education program for a child in care or if the child in care does not appear to be making progress;

(3) attend ARD, IEP, ITP meetings, or other school staffings and conferences to represent the educational best interests of a child in care; and

(4) know what is in the IEP or ITP for a child in care and support the school's efforts to implement the IEP or ITP, if applicable.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600412

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

SUBCHAPTER N. MEDICAL AND DENTAL REQUIREMENTS

26 TAC §§749.1501, 749.1503, 749.1505

STATUTORY AUTHORITY

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1501. General Medical, Dental, and Medication Requirements.

(a) A child in care must receive timely routine and emergency medical and dental care.

(b) At admission, a child-placing agency (CPA) must verify whether a child in care has had a medical examination within the past year and a dental examination within the past year, if the child in care is at least six months old. If the CPA determines that a child in care has not had one of these examinations during that time frame, the CPA must schedule any medical or dental examinations the child in care may need.

(d) The CPA must ensure caregivers follow orders and recommendations from a physician or other health-care professional.

(e) All medications must be stored securely and properly according to the label's instructions and in a way that makes the medications inaccessible to children in care.

§749.1503. Immunization Requirements.

A child-placing agency must ensure each child in care meets and continues to meet applicable immunization requirements as specified by the Texas Department of State Health Services.

§749.1505. Documentation Requirements for Medical and Dental Care.

(a) A child-placing agency (CPA) must verify that the following is documented either in the record or in the health passport, if applicable, of a child in care:

(1) each medical and dental visit or hospitalization, including a discharge summary;

(2) applicable immunization requirements; and

(3) any known contraindicated prescription, non-prescription medications, and supplements.

(b) The foster home must document and maintain in the record of a child in care:

(1) a daily medication log for each prescription medication administered to a child in care of any age, and non-prescription medication or supplement dispensed to a child in care under five years old; and

(2) documentation of all medication errors, adverse reactions, and side effects of a medication.

(1) the name of the child in care and the person who administered the medication or supplement;

(2) the name, strength, and dosage of the medication or supplement administered; and

(3) the date and time the medication or supplement was administered.

(d) The CPA must provide the documentation form for medication errors, adverse reactions, and side effects to the foster parents. The form must include:

(1) the name of the child in care;

(2) the name of the medication;

(3) a description of the error, adverse reaction, or side effect; and

(4) how the caregiver ensured the safety of the child in care.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600413

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

SUBCHAPTER O. EMERGENCY BEHAVIOR INTERVENTION REQUIREMENTS

DIVISION 1. ADMINISTERING EMERGENCY BEHAVIOR INTERVENTION

26 TAC §§749.1601, 749.1603, 749.1605, 749.1607

STATUTORY AUTHORITY

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1601. Types of Emergency Behavior Intervention (EBI).

(a) A child-placing agency (CPA) must use a method of emergency behavior intervention (EBI) recognized by Child Care Regulation.

(b) EBI may only be used in a situation where preventative de-escalation and redirection has not effectively reduced the risk of injury, so immediate intervention is necessary to prevent:

(1) imminent probable death or substantial physical injury to the child in care; or

(2) imminent physical harm to another individual because of the overt actions of a child in care.

(c) A caregiver may only implement EBI using personal restraints, short personal restraints, and emergency medication. A caregiver may not use chemical restraints, mechanical restraints or seclusion.

(d) A personal restraint uses physical force to restrict free movement of all or part of the body of a child in care to control physical activity. Only a caregiver allowed by the CPA's policies and trained in the CPA's EBI curriculum may administer a personal restraint.

(e) A transitional hold is a temporary restraint technique that lasts no longer than one minute as part of the continuation of a longer personal restraint.

(f) Short personal restraints are personal restraints lasting no longer than one minute that are used in urgent situations. Any caregiver may administer a short personal restraint.

(g) Emergency medications to modify the behavior of a child in care. Only a caregiver allowed by the CPA's policies and trained in the CPA's EBI curriculum may administer an emergency medication.

§749.1603. Administering Emergency Behavior Intervention (EBI) Requirements.

(a) Before administering an emergency behavior intervention (EBI), a caregiver must determine if an emergency situation exists.

(b) During an EBI, the caregiver must:

(1) use the minimal amount of reasonable and necessary physical force;

(2) protect the health, safety and well-being of a child in care; and

(3) explain to the child in care what behaviors are necessary to be released from the short personal or personal restraint and consider actions the caregiver can take to help the child in care de-escalate.

§749.1605. Restraint Minimum Safety Requirements.

(a) A caregiver must ensure each personal restraint and short personal restraint meets the following safety standards:

(1) the caregiver must ensure the child in care can still breathe, the airway of the child in care is not blocked, the caregiver can see the face of the child in care clearly, and the child in care can talk or show if the child in care is in distress;

(2) the limbs of the child in care are not twisted or placed behind the back of the child in care; and

(3) prone and supine restraints are only used:

(A) as a transitional hold during a personal restraint lasting no longer than one minute; and

(B) when other less restrictive interventions have proven to be ineffective.

(b) A child in care must be released from a personal restraint:

(1) immediately when an emergency health situation occurs, when emergency medication is administered, if applicable, or as soon as the emergency that initiated the intervention no longer exists; and

(2) no longer than 30 minutes from when the restraint was administered.

(c) A child in care must be released from a short personal restraint immediately after the danger is gone, or when the one-minute limit is reached.

§749.1607. Written Orders for Emergency Medication and Combinations of Emergency Behavior Intervention.

(a) A caregiver cannot provide emergency medicine or combinations of emergency behavior interventions to a child in care without a written order from a licensed physician or licensed psychiatrist.

(b) A child-placing agency (CPA) must ensure that the written orders are given to the parent and all the caregivers of a child in care. The CPA must ensure the caregivers follow these orders and that each order is placed in the record of the child in care.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600414

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 2. FOLLOW-UP ACTIONS AND DOCUMENTATION

26 TAC §§749.1621, 749.1623, 749.1625

STATUTORY AUTHORITY

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1621. Restraint and Emergency Medication Follow-Up Actions Requirements.

(a) After the implementation of a personal restraint or use of emergency medication, the caregiver must:

(1) watch the child in care for signs of distress and talk to the child in care about what happened, including:

(A) the situation that required the implementation of the personal restraint or use of emergency medication;

(B) the ways the caregiver tried to de-escalate the child in care before implementing the personal restraint or using emergency medication and how the child in care reacted to the de-escalation and the type of emergency behavior intervention used; and

(C) what the child in care can do to regain self-control in the future, and how the caregiver can assist the child in care to de-escalate;

(2) offer the child in care the opportunity to return to regular activities; and

(3) make reasonable efforts to debrief with any child in care who saw what happened.

(b) Each caregiver who took part in the implementation of the personal restraint or use of emergency medication must talk with child placement staff about the incident within 72 hours after the incident.

§749.1623. Restraint and Emergency Medication Documentation Requirements.

(a) The caregiver who administered the personal restraint or emergency medication must document the following information in the record of a child in care:

(1) a description of the reasons for administering the personal restraint or emergency medication, the steps taken to de-escalate the behavior of the child in care, and the reaction of the child in care;

(2) each personal restraint or emergency medication administered, the name and dose of emergency medication used, if applicable, and the length of time the child in care was restrained;

(3) the name of the caregivers who administered the personal restraint or emergency medication and all witnesses to the personal restraint or emergency medication, and the incident that led to the personal restraint or use of emergency medication;

(4) all attempts to explain to the child in care what behaviors were necessary for release from the personal restraint;

(5) the condition of the child in care following the personal restraint or use of emergency medication, including adverse effects or injuries caused by the personal restraint or emergency medication and if the child in care received medical assistance or treatment; and

(6) the post-intervention discussion with the child in care and the actions taken to facilitate the return of the child in care to normal activities.

(b) Child placement staff must document the review of the use of the personal restraint or emergency medication within 72 hours of the incident, including review of the documentation required in subsection (a) of this section.

§749.1625. Post-Restraint and Emergency Medication Parental Notification Requirements.

(a) No later than 72 hours after a personal restraint or emergency medication is administered, a child-placing agency must provide written notice to the parent of a child in care.

(b) The written notice must be maintained in the record for a child in care, and include:

(1) each personal restraint or emergency medication administered, including the name and dose of emergency medication used, if applicable, and the length of time the child in care was restrained; and

(2) the child's condition following the personal restraint or use of emergency medication, and if the child received medical assistance or treatment.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600415

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269

DIVISION 3. TRIGGERED REVIEWS AND ANNUAL OPERATION EVALUATION

26 TAC §§749.1631, 749.1633, 749.1635

STATUTORY AUTHORITY

The new sections affect Texas Government Code §524.0151 and HRC §42.042.

§749.1631. Triggered Reviews General Requirements.

(a) For a child in care, a triggered review of the placement, service plan, and orders or recommendations for emergency behavior intervention (EBI) for the child in care must occur no later than 30 days after:

(1) a personal restraint is administered on the same child in care:

(A) four times or more within a seven-day period;

(B) 13 times or more in a single 30-day period; or

(2) a caregiver administers emergency medication to the same child in care three times in a 30-day period.

(b) The service planning team for the child in care must participate in the triggered review. The child in care must be invited to participate.

(1) a mental health professional must examine the child in care to make recommendations regarding the use of EBI; and

(2) a child-placing agency must follow the mental health professional's recommendations.

§749.1633. Triggered Reviews Documentation Requirements.

(a) A child-placing agency must document and maintain the following when conducting a triggered review:

(1) a review of the records and orders of the emergency behavior interventions (EBI);

(2) a review of any potential medical or psychiatric reason for not using EBI on the child in care;

(3) identified behaviors and patterns, any significant events leading to the use of EBI, and attempted de-escalation methods; and

(4) alternatives to manage the behavior of the child in care and prevent the use of EBI in the future.

(b) Triggered reviews and any associated recommendations must be documented and maintained in the record of the child in care.

§749.1635. Annual Operation Evaluation.

(a) A child-placing agency (CPA) must complete an annual operation evaluation, which is a written review to ensure any type of emergency behavior intervention (EBI) is used safely, correctly, and effectively. During the evaluation, the CPA must document and review:

(1) the CPA's EBI policies and procedures, including the training policy and curriculum;

(2) the frequency, patterns, and effectiveness of the types of EBI techniques used in the CPA's foster homes;

(3) strategies to reduce the need for specific types of EBI used in the CPA's homes; and

(4) strategies to reduce the need for EBI at the CPA's homes overall.

(b) Every three months, the CPA must:

(1) collect, document, and review aggregate numbers of EBI by type of intervention; and

(2) report the information to Child Care Regulation no later than 15 days after the end of each quarter.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 30, 2026.

TRD-202600416

Karen Ray

Chief Counsel

Health and Human Services Commission

Earliest possible date of adoption: March 15, 2026

For further information, please call: (512) 438-3269