With the rise in extreme events affecting public health—mostly recently Hurricane Harvey in 2017 and the COVID-19 crisis in 2020—the question of how public health services are delivered in Houston and Harris County has been given new currency.

Most large Texas cities are served by one public health agency. Sometimes that agency functions at the county level (as with Dallas County Health and Human Services) or at the city level (as with the San Antonio Metropolitan Health District, which provides services countywide but functions essentially as a city department). But in Houston, the Harris County Department of Public Health and the City of Houston Department of Health and Human Services both provide public health services, albeit mostly within different geographies.

The purpose of this report is to take a fresh look at possible service overlaps between the Harris County Department of Public Health and the City of Houston Department of Health and Human Services and identify options to reduce those overlaps and increase the efficiency and effectiveness of the public health delivery system.

Issues