Texas Department of State Health Services, or DSHS, said it needs additional funding to meet expectations of state policymakers and to maintain critical public health infrastructure.
On Friday, DSHS officials presented the agency's legislative appropriations request to state officials ahead of budget discussions during the 2027 legislative session. The agency asked for more than $230 million in additional funding beyond the agency's base budget — including funding to support local agencies, maintain programs and hire additional staff.
Imelda Garcia, interim DSHS commissioner, said the additional funding doesn't cover anything new or "fancy."
"It is about the meat and potatoes of core public health functions and maintaining the operations and the mandates we've been directed to do," she said.
Increased need and lost federal funding
Garcia said the agency is seeing higher costs to complete core functions, like disease monitoring, infectious disease treatment and disaster response.
In addition to funding to maintain several IT and data systems that play a key role in disease management and response, DSHS is asking for more support for local health departments as federal cuts threaten services.
DSHS has already been preparing to lose federal COVID-19 grants, but now it's worried about another program expected to end soon.
The agency's CFO, Christy Havel Burton, said the Public Health Infrastructure Grant, or PHIG, will stop at the end of November 2027.
"PHIG in particular has been a critical source of funding for the local health departments," she said. "The end of the grant will be significant for the field."
Havel Burton and Garcia said they're worried about what this means for disaster response and infectious disease monitoring throughout the state.
Garcia said DSHS already has to move money around to ensure public health officials are able to respond to crises.
"Whether it's Ebola, whether it's activities with the World Cup, floods, hurricanes, wildfires, the agency must respond to those," she said. "We do not have a dedicated fund in order to be able to cover the costs associated with those."
While some disasters end up being federally reimbursed, Garcia said many aren't – which is why federal grant funding was such a powerful tool to help local departments have stable support.
"Our local health department are the boots on the ground for all public health within their communities and they are essential partners," she said. "All disasters are local…If there's an emerging public health threat, the local health departments are the ones that are first to respond."
The agency is requesting $20 million from state lawmakers to support local health department capacity.
Garcia said DSHS also needs additional funding to maintain the Texas HIV Medication Program, which serves about 24,000 lower-income Texans living with HIV.
She said there have been significant federal policy changes that have affected how much federal funding and rebates the state has been able to get. Those changes come at a moment when the need for HIV support services is on the rise in Texas.
"We have higher numbers of HIV diagnoses occurring," Garcia said. "Then, as the economy shifts and people lose insurance, they become newly eligible for the programs."
Garcia said DSHS is asking for $69 million to sustain that program, which is expected to see a funding shortfall starting this fiscal year. She said that amount assumes there are no changes in current eligibility for the medication program.
More inspection responsibilities requiring more staff
Garcia said the agency needs more than 110 additional full-time employees — 80 of them are to fulfill legislative mandates and executive directives related to food trucks and consumable hemp.
Last year, Gov. Greg Abbott issued an executive order mandating age restrictions for consumable hemp products, including gummies, beverages, pre-rolls and concentrate containing THC. DSHS was one of the main agencies put in charge of designing and implementing the new rules.
Garcia said between fiscal year 2025 and 2026, there was an 82% increase in THC retailers — which adds more pressure on DSHS's current workforce of full-time employees.
She said with the current number of full-time workers, DSHS can run inspections once every five to six years on THC retailers.
"We would like to be able to get that to once every one to two years," Garcia said. "In particular to be able to verify the age gating and making sure that none of the retailers are selling to minors."
In addition, under a new state law that went into effect this summer, DSHS is in charge of rolling out a new statewide license for food trucks. Garcia estimates there are about 20,000 food trucks across the state.
"We had to stand this up very, very quickly in order to be able to offer this license by the effective date of the bill," she said. "Because of the requirements that were laid out in statute, we not only need the licensing staff – the inspectors – but also had to issue contracts with our local health departments in order for them to do the inspections on the ground."
DSHS delegated the inspections to local health departments in order to meet timeliness expectations also laid out in the law.
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