The 79th Legislature established local health authorities in statute. The statute permits but does not require local governments to perform public health functions, including the appointment of a local health authority. The state is expected to perform the functions if local governments opt out.

In Texas, counties are not required to have a public health department or a local health authority. If a local jurisdiction elects to have a local health authority, their local governing body appoints one. If a county or municipality elects not to appoint a local health authority, a director of one of the state’s regional health departments acts as that county’s health authority. Less than a third (29%) of the 254 Texas counties have an appointed local health authority.

Local health authorities must be physicians licensed to practice medicine by the Texas State Board of Medical Examiners and may administer state and local laws relating to public health within a particular local jurisdiction.  They operate as officers of the state charged with a variety of duties, including establishing, maintaining, and enforcing quarantine; aiding the local or regional department in relation to local quarantine, inspection, disease prevention and suppression, birth and death statistics, and general sanitation; reporting the presence of contagious, infectious, and dangerous epidemic diseases to the state health department in the manner and at the times prescribed by said department; reporting to the department on any subject on which it is proper for the department to direct that a report be made; and assisting the state health department in the enforcement of rules, laws and ordinances regarding sanitation, quarantine and vital statistics collection.

There is no comprehensive list of local health authorities available. There also appears to be widely varying roles and functions of these authorities across the state.