The Harris County Hospital District was created by voter referendum in November 1965 and formally came into being as a political subdivision with taxing authority on January 1, 1966. The new district replaced an existing city-county system in which the two governmental bodies shared funding responsibility. Annually at budget time, controversy arose between the two entities as each accused the other of not providing an equal share of budget dollars for the Hospital District. Therefore, before formation of the Hospital District, public health for the city and county’s indigent and needy citizens was hit-or-miss. Doctors served on a contract basis. 

Today the Harris County Hospital District provides access to cost-effective, quality health care delivered in a compassionate manner to all residents of Harris County regardless of their ability to pay. 

The Hospital District is governed by a board of managers appointed by the Harris County Commissioners Court. In the Hospital District’s inaugural year, the seven-member Board requested a 1966 operating budget of $7 Million, but was forced to return to Commissioners Court after one month for an increase. The annual operating budget was increased to $23 Million.

In 1985 Public Law 281 was revised to increase the Board of Managers from seven to nine members to better represent the ethnic mix of the community.

Early Milestones

1888: A health care charity unit was established in Houston at the St. Joseph Infirmary. Twenty-one years later a city-county hospital opened, and in 1924 the 150-bed Jefferson Davis Hospital was built at 1101 Elder Street.

1938: A new Jefferson Davis Hospital was constructed on the south bank of Buffalo Bayou on Allen Parkway. The 11-storey, 500-bed Jefferson Davis Hospital, which replaced the old Elder Street facility, was financed with a $2.5 Million bond. 

Jeff Davis had no intensive care units; patients were treated in open wards. The trauma center consisted of one shock room, two treatment rooms, and two holding areas. In 1949, Baylor College of Medicine agreed to provide medical services to Jeff Davis Hospital. 

District Development

1963: The annual budget debate raged at the City of Houston. A city council member proposed to cut the portion of the budget set aside for Jeff Davis Hospital. In response, author and Jeff Davis hospital volunteer Jan De Hartog composed an editorial for the Houston Chronicle on April 21, 1963, a paragraph of which follows: 

I would like to show him the emergency room, where I have worked as volunteer orderly for eight months now: the hall with the stretchers that are never empty, the two dark wards in the back where, because of the lack of staff, the sick, the drunk, the desperate and the dying are often ditched into the cold sagging beds fully dressed... 

The City fully funded its portion of the Hospital’s budget that year.

In May the newly constructed 431-bed Ben Taub General Hospital opened, replacing the overcrowded Jefferson Davis as the county’s general hospital. The hospital was named for Mr. Ben Taub, a longtime advocate for healthcare of the indigent. Ben Taub’s high standard of emergency care had been set in the 1940s at Jefferson Davis, when that hospital emerged as a trauma center because of the high number of Harris County citizens taken there with serious injuries.

By default, Jeff Davis had developed into Houston’s major trauma center because such a high volume of badly injured citizens were taken there. Jeff Davis thus set care standards when Ben Taub Hospital was built in 1963. 

The American College of Surgeons and the Texas Department of Health designated Ben Taub Hospital’s Trauma Center as the first Level I Trauma Center in South Texas.

1964: Author Jan De Hartog published a book describing the horrific squalor and neglect he had witnessed while volunteering in Houston’s local charity hospital. 

1965: De Hartog’s book The Hospital created such a public furor that the Texas Legislature passed an act to allow Harris County citizens to consider creating a hospital district. At the next election, voters voiced their strong support for public health care by passing the ballot item by a 2-to-1 margin, thus creating a hospital district and ensuring a more predictable funding source.

1966: A newly appointed Board of Managers collaborated with the Community Medicine Department of Baylor College of Medicine to determine how best to reduce the tremendously heavy volume of non-emergency cases seen at the Hospital District’s two general hospitals. The Harris County Hospital District, in cooperation with Baylor, created the Community Health Center Program to provide non-emergency primary care close to patients’ homes. By 1968, the first two community health care clinics opened. During the next 29 years, 12 clinics were opened throughout Harris County. 

1973: Dr. Carlos Vallbona, director of Baylor’s Community Medicine, received a grant of $525,000 to teach new doctors about health care outside the hospital setting. Dr. Vallbona used the Community Health Centers to launch his program. 

1983: Quentin Mease Community Hospital, a 48-bed facility, was added to the Hospital District’s health care system. Named for Harris County Hospital District’s long-time chairman of the Board of Managers, Quentin Mease Hospital specializes in geriatrics and long-term physical rehabilitation. The facility was named to honor Mr. Quentin Mease for 25 years of service as a member of the Board of Managers. Mr. Mease served as chairman of the board for 19 of those years. 

1989: The Thomas Street Health Center, a Southern Pacific railroad hospital facility owned by Harris County, was given lease-free to the Hospital District as an outpatient facility for HIV/AIDS–infected patients. It was the first free-standing HIV/AIDS center in the United States. In its first year Thomas Street saw some 800 patients; today there are 4,400. The historic center offers general medicine, outpatient IV therapy, pharmacy, blood transfusions, chemotherapy, oncology, radiology, psychiatry, rheumatology and dermatology.

Lyndon B. Johnson General Hospital opened in June 1989 in Houston’s near-north side. Before that time the county’s northeast quadrant had no sophisticated health care delivery facility. When the new 324-bed facility opened, the 51-year-old Jefferson Davis Hospital was closed. LBJ was the first hospital in Texas to receive an official designation as a Level III emergency center. It is a teaching

site for the University of Texas Medical School at Houston and is staffed by UT’s faculty and residents. LBJ Hospital is known for its excellence in obstetric, neonatal and oncology care.   

1990: In January the newly constructed 578-bed Ben Taub General Hospital replaced the old Ben Taub facility. Located adjacent to its namesake, the newer pavilion has 755,000 square feet of space.

World-renowned Ben Taub excels in surgery, physical therapy, pediatrics, obstetrics, and neonatology, and has a full complement of specialty clinics. 

With the Houston Fire Department, Ben Taub has one of the world’s finest emergency care systems. Nearly 80% of HFD’s life-threatening ambulance runs come to Ben Taub’s Trauma Center, which provides all medical and surgical specialties around the clock. 

Integrated Health Care Delivery

The Harris County Hospital District provided integrated health care to the community long before this approach was adopted by other hospitals.  

In the 1950s, Mr. Ben Taub, chairman of the board of Jefferson Davis Hospital, contacted Dr. Michael DeBakey, then-chairman of surgery at Baylor College of Medicine. The two devised a plan to make Jeff Davis Hospital a teaching facility for Baylor. Thus began a unique relationship that was later expanded to include The University of Texas Health Science Center—Houston.  

Baylor College of Medicine faculty and residents staff Ben Taub General Hospital, Quentin Mease Community Hospital, and six community health centers, while The University of Texas Health Science Center staffs LBJ Hospital and five community centers. The Thomas Street Clinic is jointly staffed by both Baylor and The University of Texas.

In an effort to better meet the health care needs of the community, the Harris County Hospital District, in conjunction with five school districts, has established seven school-based clinics in areas of the community that need it most. HCHD’s school-based clinics provide health care to children in neighborhoods with limited healthcare services, and enable early detection of illness and intervention, as well as help promote children's health issues.

With the goal of improving the health of the medically underserved pediatric population of Harris County, the Harris County Hospital District operates the TroubleShooting for Health Mobile Program.

  

Homeless Program

The Hospital District historically has recognized the importance of integrating primary health care into the lives of the public, including the homeless population. Begun in 1986, the Harris County Hospital District’s Homeless Program, whose goal is to avoid long-term health problems and costly hospitalizations for the homeless, is entirely grant-funded. Medical personnel staff 11 area shelters for the homeless, providing assessment, referral and immunization services.  

Chaplaincy Program

Recognizing that patient care reaches beyond medical care, the Hospital District has a tradition of attention to patients’ and families’ social and spiritual needs.

The Chaplaincy Department is a critical part of the integrated system. Hospital District chaplains are available on-site or on-call throughout the hospitals and clinics. The department offers several training options in clinical pastoral education, including a year-long residency with a clinical, pastoral and educational focus. Students from around the world come to the Harris County Hospital District to receive this training. 

Social Services in the Harris County Hospital District might be called a bridge in the continuum of care. Social workers help patients and their families cope with illness and learn about healthy lifestyles; they also are skilled in crisis intervention and counseling.
 

District Structure

 Board of Managers

The Harris County Hospital District is governed by a nine-member Board of Managers appointed to two-year, extendible terms by the county’s commissioner’s court.  

According to the Board of Managers bylaws, the Board “will concern itself primarily with matters of policy, seeking advice from the medical staff members and whatever other sources it deems advisable.” 

The Board of Managers meets monthly in committees and in public and executive sessions. Board committees include audit oversight, technology oversight, buildings and property, clinic, fiscal affairs, joint conference, personnel, and public affairs. 

President and Chief Executive Officer

The Board of Managers appoints and delegates to the President and CEO administrative responsibilities. According to the Texas Health and Safety Code, the CEO supervises all work and activities of the Hospital District and has general direction of the District within limitations that may be prescribed by the Board of Managers.