TITLE 25. HEALTH SERVICES

PART 1. DEPARTMENT OF STATE HEALTH SERVICES

CHAPTER 31. NUTRITION SERVICES

SUBCHAPTER A. REGISTER OF TEXAS MOTHER-FRIENDLY WORKSITES [BUSINESSES]

25 TAC §31.1

The executive commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes an amendment to §31.1, concerning Register of Mother-Friendly Businesses.

BACKGROUND AND PURPOSE

The Texas Department of State Health Services (DSHS) created the "Mother-Friendly" business designation as directed by Texas Health and Safety Code Chapter 165, Breast-feeding. The Texas Mother-Friendly Worksite program provides required basic minimum criteria for the designation in Title 25 Texas Administrative Code §31.1 and maintains a listing of designated worksites.

The proposal updates the rule to reflect the program name, Texas Mother-Friendly Worksite Program; updates program contact information and application processes; introduces a redesignation process to ensure program integrity; and updates voluntary Silver and Gold standards for level designation criteria to align with worksite lactation best practices that reflect changes in business practice and technology.

SECTION-BY-SECTION SUMMARY

The proposal updates the title of Subchapter A and the title of the rule to Register of Texas Mother-Friendly Worksites. The proposed amendment includes non-substantive editorial and plain-language changes and revisions to improve clarity that are not specifically enumerated here.

The proposed amendment to subsection (a) updates definitions for clarity and adds the definition for "Texas Mother-Friendly Worksite."

The proposed amendment to subsection (b) updates program required basic minimum standards; adds reference to Texas Health and Safety Code §165.003; meets current worksite lactation program best practices; and adds language in support of a dispute resolution process.

The proposed amendment to subsection (c) updates voluntary program Silver and Gold standards for level designation criteria to align with worksite lactation best practices that reflect changes in business practice and technology; meets current worksite lactation program best practices; and increases worksite resource options made available to breastfeeding and breast pumping employees and their family members.

The proposed amendment to subsection (d) updates program contact information, and updates application guidance.

The proposed amendment to subsection (e) updates program contact information; clarifies standards for worksite maintenance of Texas Mother-Friendly Worksite designation; and updates compliance and monitoring of designated worksites.

FISCAL NOTE

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

GOVERNMENT GROWTH IMPACT STATEMENT

DSHS has determined that during the first five years that the rule will be in effect:

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

(2) implementation of the proposed rule will not affect the number of DSHS employee positions;

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

(4) the proposed rule will not affect fees paid to DSHS;

(5) the proposed rule will not create a new regulation;

(6) the proposed rule will not expand, limit, or repeal existing regulation;

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

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

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

Christy Havel Burton has also determined that there will be no adverse economic effect on small businesses, micro-businesses, or rural communities because there is no requirement to alter current business practices. The rule does not impose any additional costs on small businesses, micro-businesses, or rural communities that are required to comply with the rule.

LOCAL EMPLOYMENT IMPACT

The proposed rule will not affect a local economy.

COSTS TO REGULATED PERSONS

Texas Government Code §2001.0045 does not apply to this rule because the rule does not impose a cost on regulated persons and the rule is necessary to implement legislation that does not specifically state that Section 2001.0045 applies to the rule.

PUBLIC BENEFIT AND COSTS

Manda Hall, M.D., Deputy Commissioner, Community Health Improvement Division, determined that for each year of the first five years the rule is in effect, the public benefit will be that Texas Mother-Friendly Worksites will update lactation policies and introduce quality improvement initiatives to provide more support to breastfeeding and breast pumping employees.

Christy Havel Burton has also determined that for the first five years the rule is in effect, there are no anticipated economic costs to persons who are required to comply with the proposed rule because the rule does not establish a cost to meet the guidelines.

TAKINGS IMPACT ASSESSMENT

DSHS 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 26R043" in the subject line.

STATUTORY AUTHORITY

The amendment is authorized by Texas Health and Safety Code §165.003, which authorizes the department to maintain a list of mother-friendly businesses. The amendment is also authorized by Texas Government Code §524.0151 and Texas Health and Safety Code §1001.075, which authorize the executive commissioner of HHSC to adopt rules for the operation and provision of health and human services by DSHS and for the administration of Texas Health and Safety Code Chapter 1001.

The amendment affects Texas Government Code §524.0151 and Texas Health and Safety Code Chapters 165 and 1001.

§ 31.1. Register of Texas Mother-Friendly Worksites [Businesses].

(a) Definitions. The following terms [words and terms, when used] in this subchapter[, shall] have the following meanings[,] unless the context clearly indicates otherwise.

[(1) Mother-friendly business--A worksite that actively promotes and supports breastfeeding by its employees and that maintains a written worksite lactation support policy that is regularly communicated to employees.]

(1) [(2)] DSHS--Texas [Department--] Department of State Health Services.

(2) Texas Mother-Friendly Worksite--A DSHS designated worksite promoting and supporting the pumping of breast milk and breastfeeding by mothers. The worksite must have a written lactation support policy shared with employees.

(b) Basic minimum [Minimum] standards. A Texas Mother-Friendly Worksite [To be designated mother-friendly, a worksite] must provide as a best practice, a dispute resolution process for employee complaints related to worksite lactation policies and follow requirements of Texas Health and Safety Code §165.003 to:

(1) meet [adhere to] the definition of a Texas Mother-Friendly Worksite [mother-friendly business];

(2) provide time at work and a flexible schedule for a mother to pump breast milk or breastfeed after the child's birth for two years or longer as a best practice [schedule and work pattern flexibility to, at a minimum, accommodate a reasonable break time for an employee to express breast milk for her nursing child or breastfeed each time such employee has need to express the milk or breastfeed for one year or longer after the child's birth];

(3) provide mothers [employees] a private, accessible area, other than a bathroom, [that is] shielded from view and free from intrusion from coworkers and the public, including during video conferencing, for pumping [either expressing] breast milk or breastfeeding each time there is a biological [such employee has] need [to express breast milk or breastfeed];

(4) provide access to [a] clean, safe water for washing hands and rinsing breast pumping equipment [source and a sink]; and

(5) provide access to a hygienic place to store [expressed] breast milk.

(c) Silver and Gold Level Standards. DSHS [gold standards. The department] may designate Texas Mother-Friendly Worksites voluntarily exceeding [recognize mother-friendly businesses that implement additional best practice policies and program activities to promote and support breastfeeding by their employees that exceed the] minimum standards in subsection (b) of this section if: [by silver or gold designation of those worksites.]

(1) A Texas Mother-Friendly Worksite meets [To be eligible for silver designation, a worksite must meet] the minimum standards in subsection (b) of this section as well as the following best practice standards for a Silver Level:

(A) provide a private lockable space only used for pumping breast milk or breastfeeding, and if a mother is using a personal or company car to pump breast milk or breastfeed, provide window shields for privacy [break room space with a locking door that is dedicated for use only by employees who are breastfeeding or expressing breast milk];

(B) provide at least one of the following items within the private lockable space for pumping breast milk or breastfeeding unless a mother is 100 percent telework [use in the dedicated break room space]:

(i) a hospital-grade multi-user electric breast pump for which mothers [employees] provide an accessory kit for personal use [their own access kits];

(ii) a sink with hot and cold running water or a heating source to boil water, [and] a supply of soap, [and] paper towels, and hand sanitizer; [and]

(iii) a refrigerator or personal cooler [coolers] for breast milk storage; or

(iv) a full-length mirror to review and adjust clothing;

(C) adopt a written lactation support policy allowing mothers [authorizing employees] to choose [select] one or more of the following options to pump breast milk or breastfeed, or both [facilitate breastfeeding and/or expression of breast milk]:

(i) part-time work [or work for some hours at home];

(ii) flexible [individualized scheduling of] work hours [(flex time)];

(iii) job-sharing;

(iv) shortened [compressed] work week;

(v) telework [telecommuting];

(vi) payment for work time during pumping breast milk, breastfeeding, or both [time taken for breastfeeding and/or breast milk expression as work time];

(vii) on-site childcare; or

(viii) care of [her] baby by the mother at or near the workstation [her work station] for the first several months after the mother's return to work from maternity leave;

(D) provide information about the worksite's written lactation [breastfeeding] support policy to [all] employees and supervisors within six months of employment and at least annually after [thereafter]; and

(E) make three or more of the following resources available to [expectant and parenting] employees:

(i) a lending library of breastfeeding pamphlets, books, or [and/or] videos;

(ii) contact information for local or state breastfeeding resources such as lactation consultants, support group meetings, and [and/or] other community breastfeeding resources;

(iii) a forum, blog, or other electronic networking opportunity for breastfeeding peer [mother-to-mother] support [among employees];

(iv) classes on pregnancy and breastfeeding offered at the worksite;

(v) facilities for regular support group meetings at the worksite;

(vi) breast pump kits or spare parts purchased by the worksite or by the employee with partial support from the worksite;

(vii) [(vi)] access to an International Board Certified Lactation Consultant or other lactation expert as an employee benefit;

(viii) an information sheet on employer insurance providers and benefits related to lactation support services and lactation supplies;

(ix) a breast pumping or breastfeeding support plan for mothers entering maternity leave;

(x) information on breastfeeding and the benefits to employee and infant health in an existing employee newsletter or circular on a yearly basis;

(xi) [(vii)] a breast pumping or breastfeeding support program by [coordination of the worksite breastfeeding support program by] a skilled lactation expert [hired by the worksite]; or

(xii) [(viii)] breastfeeding education or other supports for [offered to employees'] partners not pumping breast milk or breastfeeding and for an employee's partner who is pregnant or pumping breast milk or breastfeeding [who are expectant fathers].

(2) A Texas Mother-Friendly Worksite meets [To be eligible for gold designation, a worksite must meet] the minimum standards in subsection (b) of this section as well as the following best practice standards for a Gold Level:

(A) provide a private lockable space only used for pumping breast milk or breastfeeding, and if a mother is using a personal or company car to pump breast milk or breastfeed, provide window shields for privacy; the number of spaces provided must meet the following as outlined by the United States Department of Health and Human Services, Office of Women's Health: [break room space with a locking door that is dedicated for use only by employees who are breastfeeding or expressing breast milk;]

(i) fewer than 100 employees: one space;

(ii) approximately 101 to 250 employees: two spaces;

(iii) approximately 251 to 500 employees: three spaces;

(iv) approximately 501 to 750 employees: four spaces;

(v) approximately 751 to 1,000 employees: six spaces; or

(vi) for every additional 1,000 employees: six additional spaces;

(B) provide all [of] the following items, unless a mother is 100 percent telework [for use in the dedicated break room space]:

(i) a hospital-grade multi-user electric breast pump, or a personal portable electric breast pump [for each breastfeeding employee] purchased by the worksite or by the employee with partial support from the worksite;

(ii) a sink with hot and cold running water or a heating source to boil water, [and] a supply of soap, [and] paper towels, and hand sanitizer; and

(iii) a full-length mirror to review and adjust clothing [a refrigerator for breast milk storage];

[(iv) a bulletin board; and]

[(v) a telephone;]

(C) provide two or more of the following:

(i) a refrigerator for breast milk storage;

(ii) a bulletin or information exchange board;

(iii) access to a telephone or available charging station for personal mobile phone;

(iv) white noise machine or Bluetooth speaker; or

(v) lockers or hooks for belongings;

(D) [(C)] adopt a written lactation support policy allowing mothers [authorizing employees] to choose [select any or all of] the following options to pump breast milk or breastfeed, or both [facilitate breastfeeding and/or expression of breast milk]:

(i) at least six weeks of paid maternity leave;

(ii) telework [telecommuting];

(iii) on-site childcare;

(iv) care of [her] baby by the mother at or near the workstation [her work station] for the first several months after the mother's return to work from maternity leave; and

(v) payment for work time during pumping breast milk, [time taken for] breastfeeding, or both [and/or breast milk expression as work time];

(E) [(D)] provide information about the worksite's written lactation support [breastfeeding support] policy to [all] employees and supervisors within six months of employment and at least annually after [thereafter];

(F) participate in at least one of the following to support program quality improvement:

(i) complete an employee needs assessment at least every two years;

(ii) complete a program quality improvement assessment at least every two years to measure the impact of Texas Mother-Friendly Worksite policies and standard levels;

(iii) start a shared use agreement with another employer, sponsor a yearly community event, or participate on a community health improvement planning committee;

(iv) agree to mentor employers pursuing DSHS Texas Mother-Friendly standard levels; or

(v) provide training for leaders and managers, at least annually, that covers how to support pumping or breastfeeding mothers, including the use of DSHS resources available at dshs.texas.gov/TexasMotherFriendly; and

(G) [(E)] make five or more of the following resources available to [expectant and parenting] employees:

(i) a lending library of breastfeeding pamphlets, books, or [and/or] videos;

(ii) contact information for local or state breastfeeding resources, such as lactation consultants, support group meetings, and [and/or] other community breastfeeding resources;

(iii) a forum, blog, or other electronic networking opportunity for breastfeeding peer [mother-to-mother] support [among employees];

(iv) classes on pregnancy and breastfeeding offered at the worksite;

(v) facilities for regular support group meetings at the worksite;

(vi) breast pump kits or spare parts purchased by the worksite or by the employee with partial support from the worksite;

(vii) [(vi)] access to an International Board Certified Lactation Consultant or other lactation expert as an employee benefit;

(viii) an information sheet on employer insurance providers and benefits related to lactation support services and lactation supplies;

(ix) a breast pumping or breastfeeding support plan for mothers entering maternity leave;

(x) information on breastfeeding and the benefits to employee and infant health in an existing employee newsletter or circular on an annual basis;

(xi) [(vii)] a breast pumping or breastfeeding [coordination of the worksite breastfeeding] support program by a skilled lactation expert [hired by the worksite]; or

(xii) [(viii)] breastfeeding education or other supports for [offered to employees'] partners not pumping breast milk or breastfeeding and for an employee's partner who is pregnant or pumping breast milk or breastfeeding [who are expectant fathers].

(d) Application for consideration [designation] as a Texas Mother-Friendly Worksite [mother-friendly business]. To apply for Basic, Silver, or Gold Standard Level [designation as a mother-friendly business], a worksite must:

(1) complete a Texas Mother-Friendly Worksite [mother-friendly] application. Applications are available at dshs.texas.gov/TexasMotherFriendly, or by emailing TexasMotherFriendlyWorksite@dshs.texas.gov [from the Mother-Friendly Worksite Program, Division of Family and Community Health Services, Department of State Health Services, Mail Code 1922, P.O. Box 149347, Austin, Texas 78714-9347 and through the department's website at http://www.dshs.state.tx.us/wichd/lactate/mother.shtm]; and

(2) submit the completed application and written [worksite] lactation support policy to DSHS [the department for review]. Completed applications are [will be] reviewed by DSHS [department staff for compliance with designation standards].

(A) The review process starts [shall be completed] within 45 business [working] days following receipt of an application and written policy.

(B) Worksites that meet standard levels are notified by DSHS [the applicable standards for designation will receive a letter from the department] and sent a Basic, Silver, or Gold Standard Level Kit [certificate suitable for framing and display].

(C) Worksites not meeting standard levels are notified by DSHS [that do not meet the applicable standards for designation will be notified by letter] and [will be] offered support [technical assistance to achieve compliance].

(e) Maintaining DSHS approved standard levels [designated status]. A Texas Mother-Friendly Worksite [worksite designated as mother-friendly] must:

(1) be on the [listed as such by the department. The] list of Texas Mother-Friendly Worksites [mother-friendly worksites will be] maintained by DSHS [the department] and [made] available for public inspection;

(2) inform DSHS [keep the department informed] of any changes in the written [worksite's] lactation support policies and worksite contact; if written[. If its lactation support] policies change, a worksite must email the updated policy to TexasMotherFriendlyWorksite@dshs.texas.gov [submit an amended application];

(3) comply with DSHS standard levels [designation standards] at all times; if [. If] a worksite does not comply with DSHS standard levels, DSHS [the program's designation standards at all times, the department] may suspend or [,] revoke[, or change] the Texas Mother-Friendly Worksite standard status level; a [mother-friendly designation. A] worksite may change [amend its nonconforming] policies and [may] reapply for a Texas Mother-Friendly Worksite standard level [the mother-friendly designation. Employees and clients should direct complaints to the department about the activities of a worksite designated as mother-friendly]; and

(4) agree to [be subject to] monitoring by DSHS [the department] for compliance every two years [with rules and designation criteria biannually] and as needed [on an as-needed basis].

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 June 10, 2026.

TRD-202602355

Cynthia Hernandez

General Counsel

Department of State Health Services

Earliest possible date of adoption: July 26, 2026

For further information, please call: (512) 239-8263