TITLE 26. HEALTH AND HUMAN SERVICES

PART 1. HEALTH AND HUMAN SERVICES COMMISSION

CHAPTER 748. MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS

The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §748.751, concerning Employment Verification; §748.753, concerning Reference Checks; §748.881, concerning General Pre-Service Training Curriculum Components; §748.887, concerning Pre-Service Training Curriculum Components for General Residential Operations that Do Not Allow Emergency Behavior Intervention; §748.3319, concerning "No Trespassing" Notices for General Residential Operations Operating as Residential Treatment Centers; and the repeal of §748.3321, concerning What additional responsibilities do I have regarding the "No Trespassing" signs if my operation is a residential treatment center.

Sections 748.753, 748.887 and 748.3319 are adopted with changes to the proposed text as published in the March 20, 2026, issue of the Texas Register (51 TexReg 1797). These rules will be republished.

Sections 748.751, 748.881, and 748.3321 are adopted without changes to the proposed text as published in the March 20, 2026, issue of the Texas Register (51 TexReg 1797). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The amendments and repeal are necessary to comply with House Bill (HB) 3153 and Section 6 of HB 2789, 89th Legislature, Regular Session, 2025. The amendments are necessary to partially implement HB 16, 89th Legislature, 2nd Special Session, 2025.

HB 3153 added Texas Health and Safety Code (HSC), Chapter 811, which requires general residential operations (GROs) comply with certain employment requirements to prevent physical or sexual abuse of children.

Section 6 of HB 2789 amended Texas Human Resources Code (HRC) §42.068 to remove location and content requirements for "No Trespassing" notices at GROs that are operating as residential treatment centers. Other rule projects are underway to implement the other sections of HB 2789.

HB 16 amended HRC §42.0426 to require a residential child care facility to include crisis response training for emergency behavior intervention with a goal of limiting law enforcement involvement. A separate rule project will implement the bill for child-placing agencies.

The amendments and repeal update existing requirements for obtaining and verifying an applicant's employment history; add training for new employees regarding professional and appropriate relationships with children; include crisis response training for emergency behavior intervention with a goal of limiting law enforcement involvement; and remove location-specific and content requirements for "No Trespassing" notices.

COMMENTS

The 31-day comment period ended April 20, 2026.

HHSC received 18 comments regarding the proposed rules from four commenters. HHSC received comments from Cal Farley's Boys Ranch, Family Resource Centers of Texas, New Life Refuge, and the Texas Alliance of Child and Family Services. A summary of comments relating to the rules and HHSC responses follows.

Comment: Regarding §748.751, one commenter questioned if documenting attempts to verify employment is sufficient to meet the intent of the rule, whether employment verification has a timeframe, and, if a GRO is unable to verify employment, whether the GRO must document why the GRO did or did not hire an applicant. The commenter recommended that HHSC add a section to relevant forms where a GRO can document the GRO's assessment and why the GRO decided to hire the applicant.

Response: HHSC acknowledges the comment, and no rule revisions are needed. The rule as written allows GROs to document the applicant's employment history and the attempts to contact a previous employer for verification in the applicant's personnel file. These requirements are sufficient to effect the intent of the rule. However, HHSC acknowledges the commenter's recommendation to update relevant forms, and will consider whether to update forms.

Comment: Regarding §748.751(a), one commenter stated the amendments appear to be an improvement and provide clarity for providers.

Response: HHSC acknowledges the comment, and no rule revisions are needed.

Comment: Regarding §748.751, one commenter recommended that a legacy clause be included to ensure the rule amendments only apply to applicants hired after the date the rule amendments become effective. The commenter is concerned that a GRO may be cited for failing to conduct employment verification for employees hired before the rule effective date.

Response: HHSC disagrees that a legacy clause is needed and declines to revise the rule in response to this comment. GRO employees hired before the effective date of this rule are subject to the requirements that were in effect at the time the person was hired, not the updated requirements.

Comment: Regarding §748.751(a), one commenter recommended requiring GROs to verify, at a minimum, the last five years of employment history for an applicant. The commenter expressed concern that removing the five-year verification requirement will impose greater administrative burdens on GROs. The commenter is also concerned that the rule will result in a different employment verification process for each GRO's hiring practices, and force GROs and regulatory staff to review application documents in addition to the job application, such as cover letters, resumes, and letters of recommendation, to ensure compliance.

Response: HHSC disagrees with the comment and declines to revise the rule in response to this comment. The proposed rule language reflects requirements stated in HSC §811.003(c), which does not prescribe a minimum or maximum period of work history to be verified.

Comment: Regarding §748.751(b), one commenter expressed concern that "the operation must document" may be inconsistently interpreted by HHSC Child Care Regulation (CCR) staff, leading to subjective citations. The commenter recommended the issue be addressed with technical assistance, such as including on any form available to GROs.

Response: HHSC acknowledges the comment but declines to revise the rule because §748.751(b) clearly outlines what an operation must document when verifying an applicant's previous employment. HHSC will consider providing or updating technical assistance, forms and CCR staff training related to the rule.

Comment: Regarding §748.753, one commenter stated the rule lacks clarity, and questioned whether "check references" refers to the references a job applicant provides. The commenter stated "previous employers" may verify an applicant's employment but will not provide information as to the quality of the applicant's work or if the applicant is eligible for rehire.

Response: HHSC disagrees with the comment and declines to revise the rule in response to this comment. Section 748.753(a) requires a GRO to contact "at least two individuals unrelated to the applicant that can provide information about the applicant's suitability to work with or around children." A reference check with a "current or former employer" is only required by §748.753(b) if the applicant has work history that involves providing care or services to children. Section 748.753(c) provides documentation requirements if a GRO is unable to complete a reference check required by Section §748.753(a) or §748.753(b).

Comment: Regarding §748.753(a), one commenter suggested clarifying whether two reference checks must be completed, or whether attempts to contact two references are sufficient to meet the requirement. The commenter also recommended that CCR update any relevant form to help providers elicit information sufficient to meet the requirement.

Response: HHSC disagrees with the comment and declines to revise the rule. Section 748.753(d)(1) outlines information that must be gathered to complete the reference check. Section 748.753(c) outlines documentation requirements if a GRO is unable to complete a reference check as required by §748.753(a). However, HHSC acknowledges the commenter's recommendation to update relevant forms.

Comment: Regarding §748.753(c)(1), one commenter stated it is helpful that the language broadens the reasons for not completing the reference check beyond "refusal."

Response: HHSC acknowledges the comment, and no rule revisions are needed in response to the comment. The paragraph the commenter referred to as §748.753(c)(1) is now §748.753(c)(3) and has been revised to improve clarity.

Comment: Regarding §748.753(c)(3), one commenter stated it is unclear what CCR expects a GRO to document for the GRO's "assessment of the applicant's suitability to work with or around children." The commenter recommended CCR provide clarity in the rule regarding what the GRO's assessment must include, or provide clarity with technical assistance, such as including clarification on any form available to GROs.

Response: HHSC disagrees with the comment and declines to revise the rule in response to this comment. The paragraph the commenter referred to as §748.753(c)(3) is now §748.753(c)(1). A GRO must document the GRO's assessment of the applicant's suitability to work with or around children only if a reference check is not completed. The rule does not prescribe what this assessment must include. A GRO may choose criteria for this assessment based on the needs of the children the GRO serves. HHSC will consider providing technical assistance.

Comment: Regarding §748.753(d)(2), one commenter recommended clarifying the information a GRO should document when the GRO does not successfully complete a reference check for an applicant to avoid inconsistent interpretation by CCR staff. The commenter recommended addressing with technical assistance if CCR declines to revise the rule.

Response: HHSC disagrees with the comment and declines to revise the rule in response to this comment. Section 748.753(c) outlines the information a GRO must document when the GRO is unable to complete a reference check. A GRO may use reasonable discretion to determine what this information should include, which may vary depending on the situation. HHSC provides a form in the CCR Technical Assistance Library where a GRO can document reference checks and employment verification, including the operation's assessment of the applicant's suitability to work with children. HHSC will consider providing technical assistance.

Comment: Regarding §748.881(3), one commenter stated that while the proposed rule language follows the language of HB 3153, it is not clear how to train on the "methods for maintaining professional and appropriate relationships with children." The commenter expressed concern with CCR staff inconsistently interpreting the requirement, which may lead to more subjective citations. The commenter recommended providing technical assistance if CCR declines to revise the rule.

Response: HHSC disagrees with the comment and declines to revise the rule in response to this comment. As the commenter acknowledged, the rule language follows the language used in HSC §811.005(3) and provides a GRO flexibility in determining how the GRO should train on this topic. HHSC will consider providing technical assistance.

Comment: Regarding §748.887, one commenter recommended clarifying that this requirement refers to the child engaged in the potentially harmful behavior, not other children.

Response: HHSC agrees with the comment, and revised §748.887(5) and §748.887(6)(B) in response to clarify that these requirements refer to a child who is engaged in potentially harmful behavior.

Comment: Regarding §748.887(7), one commenter stated the proposed rule is not clear on what is included in the "crisis response strategies with a goal of limiting involvement with law enforcement" training. The commenter expressed concern with CCR staff inconsistently interpreting the requirement, which may lead to more subjective citations. The commenter recommended providing technical assistance if CCR declines to revise the rule.

Response: HHSC declines to revise the rule in response to this comment. The proposed rule language follows the language used in HRC §42.0426(b)(1). A GRO may determine what curriculum components should be included in the training and tailor the curriculum to meet the needs of the children in the GRO's care. HHSC will consider providing technical assistance.

Comment: Regarding §748.3319, one commenter recommended adding "without charge" to the rule language.

Response: HHSC agrees with the comment and revised §748.3319(b) to clarify that a GRO operating as a residential treatment center may request "No Trespassing" notices from HHSC without charge to the GRO.

Comment: Regarding §748.3319, one commenter appreciated the proposed changes to the "No Trespassing" notice requirements which appear less burdensome to providers. The commenter also expressed concern with CCR staff inconsistently interpreting the requirement due to a lack of specific requirements, which may lead to more subjective citations. The commenter recommended providing technical assistance if CCR declines to revise the rule.

Response: HHSC disagrees with the comment and declines to revise the rule. §748.3319(b) outlines the required information and dimensions a "No Trespassing" notice must include. HHSC will consider providing technical assistance.

Comment: Regarding §748.3319, two commenters expressed concern that a GRO may be cited if there is delay between when a GRO requests a "No Trespassing" notice, and when the "No Trespassing" notice is delivered to the GRO. One commenter recommended the provision of technical assistance regarding CCR's expectation for compliance when a delay exists.

Response: HHSC acknowledges the comment and will consider providing technical assistance.

Comment: Regarding §748.3319, one commenter stated the proposed amendments are appropriate and needed, and thanked CCR for its service on behalf of all Texans.

Response: HHSC acknowledges the comment, and no rule revisions are needed.

HHSC made minor editorial changes to correct formatting and use of acronyms and to clarify language in §§748.753(b), 748.753(c), 748.887, 748.3319(a), 748.3319(b) and 748.3319(c).

SUBCHAPTER E. PERSONNEL

DIVISION 8. PRE-EMPLOYMENT SCREENING

26 TAC §748.751, §748.753

STATUTORY AUTHORITY

The amendments are adopted under Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services system, and Texas Government Code §524.0005, which provides the executive commissioner of HHSC with broad rulemaking authority. In addition, the amendments to §§748.751, 748.753, 748.881, and 748.887 are authorized by Texas Human Resources Code §42.042, which requires the executive commissioner to adopt rules and minimum standards related to required qualifications and training of employees at regulated facilities; the amendments to §748.3319 and repeal of §748.3321 are authorized by Texas Human Resources Code §42.068(b), which requires the executive commissioner to adopt rules relating to the placement and design of "No Trespassing" notices.

§748.753. Reference Checks.

(a) Before hiring an applicant for a position, the operation must complete the applicant's reference checks by contacting at least two individuals unrelated to the applicant that can provide information about the applicant's suitability to work with or around children.

(b) If the applicant has work history that involves providing care or services to children, at least one reference check required by subsection (a) of this section must be completed with a current or former employer who supervised or has knowledge of the applicant's history and job performance in that role.

(c) If the operation does not complete a reference check as required by subsection (a) or (b) of this section, the operation must document:

(1) the operation's assessment of the applicant's suitability to work with or around children; and

(2) if the reference check is not completed because the operation determines that the reference is permanently unreachable, the operation must document at least two attempts to contact the reference, and any additional facts that support the operation's determination; or

(3) any other reason the reference check could not be completed.

(d) For each person hired by the operation, the operation must maintain the following information in the employee's personnel file:

(1) documentation of each reference check that includes:

(A) the reference's name;

(B) the relation of the reference to the applicant;

(D) the date of the reference check;

(E) information obtained from the reference check, documented as:

(i) a summary of the reference; or

(ii) a copy of the written information provided by the reference; and

(F) the name of the person at the hiring operation that completed the reference check; and

(2) if the operation does not successfully complete a reference check, the documentation required by subsection (c) of this section.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on August 18, 2026.

TRD-202603582

Karen Ray

Chief Counsel

Health and Human Services Commission

Effective date: September 7, 2026

Proposal publication date: March 20, 2026

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

SUBCHAPTER F. TRAINING AND PROFESSIONAL DEVELOPMENT

DIVISION 5. CURRICULUM COMPONENTS FOR PRE-SERVICE TRAINING

26 TAC §748.881, §748.887

STATUTORY AUTHORITY

§748.887. Pre-Service Training Curriculum Components for General Residential Operations that Do Not Allow Emergency Behavior Intervention.

If an operation does not permit emergency behavior intervention, the pre-service training curriculum for emergency behavior intervention must address early identification of potentially harmful behaviors and less restrictive intervention strategies and techniques. The curriculum must include:

(1) developing and maintaining an environment that supports positive and constructive behaviors;

(2) causes of behaviors that may harm a child, including aspects of the environment;

(3) early signs of behaviors that may become dangerous to a child or others;

(4) strategies and techniques a child can use to avoid harmful behaviors;

(5) teaching a child who is engaged in potentially harmful behavior to use the strategies and techniques of the operation's de-escalation protocols to avoid harmful behavior, and supporting the efforts of a child who is engaged in potentially harmful behavior to move into a state of self-control;

(6) less restrictive strategies caregivers can use to:

(A) intervene in potentially harmful behaviors; and

(B) engage a child who is engaged in potentially harmful behavior to de-escalate a situation;

(7) crisis response strategies with a goal of limiting involvement with law enforcement; and

(8) risks associated with the use of prone or supine restraints, including positional, compression, or restraint asphyxia.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on August 18, 2026.

TRD-202603583

Karen Ray

Chief Counsel

Health and Human Services Commission

Effective date: September 7, 2026

Proposal publication date: March 20, 2026

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

SUBCHAPTER P. PHYSICAL SITE

DIVISION 1. GROUNDS AND GENERAL REQUIREMENTS

26 TAC §748.3319

STATUTORY AUTHORITY

The amendment is adopted under Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services system, and Texas Government Code §524.0005, which provides the executive commissioner of HHSC with broad rulemaking authority. In addition, the amendments to §§748.751, 748.753, 748.881, and 748.887 are authorized by Texas Human Resources Code §42.042, which requires the executive commissioner to adopt rules and minimum standards related to required qualifications and training of employees at regulated facilities; the amendments to §748.3319 and repeal of §748.3321 are authorized by Texas Human Resources Code §42.068(b), which requires the executive commissioner to adopt rules relating to the placement and design of "No Trespassing" notices.

§748.3319. "No Trespassing" Notices for General Residential Operations Operating as Residential Treatment Centers.

(a) General residential operations (GROs) operating as residential treatment centers must post "No Trespassing" notices on the grounds of the GRO.

(b) A GRO acting as a residential treatment center may request "No Trespassing" notices from Child Care Regulation, as needed and without charge to the GRO, to meet the requirements in this section or create the operation's own notices. The "No Trespassing" notices must:

(1) state that entry to the property is forbidden; and

(2) be at least 8-1/2 by 11 inches in size.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on August 18, 2026.

TRD-202603585

Karen Ray

Chief Counsel

Health and Human Services Commission

Effective date: September 7, 2026

Proposal publication date: March 20, 2026

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

26 TAC §748.3321

STATUTORY AUTHORITY

The repeal is adopted under Texas Government Code §524.0151, which provides that the executive commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services system, and Texas Government Code §524.0005, which provides the executive commissioner of HHSC with broad rulemaking authority. In addition, the amendments to §§748.751, 748.753, 748.881, and 748.887 are authorized by Texas Human Resources Code §42.042, which requires the executive commissioner to adopt rules and minimum standards related to required qualifications and training of employees at regulated facilities; the amendments to §748.3319 and repeal of §748.3321 are authorized by Texas Human Resources Code §42.068(b), which requires the executive commissioner to adopt rules relating to the placement and design of "No Trespassing" notices.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on August 18, 2026.

TRD-202603584

Karen Ray

Chief Counsel

Health and Human Services Commission

Effective date: September 7, 2026

Proposal publication date: March 20, 2026

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