(a) Neglect is defined in Texas Family Code (TFC) §261.001(4) as an act or failure to act by a person responsible for a child's care, custody, or welfare evidencing the person's blatant disregard for the consequences of the act or failure to act that results in harm to the child or that creates an immediate danger to the child's physical health or safety. Medical neglect is a subset of the statutory definition of neglect and involves the following acts or omissions by a person: failing to seek, obtain, or follow through with medical care for a child, with the failure resulting in or presenting an immediate danger of death, disfigurement, or bodily injury or with the failure resulting in an observable and material impairment to the growth, development, or functioning of the child.
(b) In this section, the following terms have the following meanings:
  (1) For purposes of this section, "observable and material impairment" means discernible and substantial damage or deterioration to the child's health or physical condition, including severe pain or injury, caused by failure to seek medical attention for obvious signs of serious illness, failure to follow the advice of a medical professional, or failure to administer necessary medical care required for a child's specific health condition.
  (2) When determining if medical neglect has occurred, we will consider the person's pattern of failing or refusing to follow through with medical care, the severity of the condition, any pain the child is experiencing from lack of medical care, the possible impact of non-treatment, and the length of time the condition has persisted. (3) Medical neglect does not include the following:
    (A) Pursuant to TFC §261.111, the mere refusal to administer or consent to the administration of psychotropic medication or consent to any other psychiatric or psychological treatment if the failure does not result in substantial risk of death, disfigurement, or bodily injury or an observable and material impairment to the child's growth, development, or functioning;
    (B) Pursuant to TFC §261.001(4)(B), a decision to obtain an opinion from more than one medical provider relating to the child's medical care, transfer the child's medical care to a new provider, or transfer the child to another health care facility; or
    (C) A parent or guardian's refusal to provide a child with specific medical treatment because of a legitimately held religious belief. However, we may still request a court order to provide medical services if the child's health requires it and will investigate allegations of lack of medical care because of religious beliefs if the child's condition appears to involve medical neglect.

Source Note: The provisions of this §707.469 adopted to be effective July 15, 2020, 45 TexReg 4780; amended to be effective September 22, 2022, 47 TexReg 6250