Behavioral Health – Substance Abuse Treatment & Overdose Prevention

TeleDeputy Unit Program Overview

ARPA funds support the Harris County Sheriff’s Office (HCSO) for the TeleDeputy Unit to allow deputies to work overtime at the Emergency Dispatch Center (EDC)to respond to calls for services that do not require an on-scene law enforcement response. Response times of the HCSO have spiked in recent years due to increased calls for service, population growth, traffic saturation, and staffing levels. The HCSO has five patrol districts, serving around 1.9 million Harris County residents, and has four priorities of calls. The average response time for a Priority 1 call, including in-progress shootings, increased 28% from 2019 (13 minutes and 32 seconds) to (17 minutes and 18 seconds) by the program’s launch in September 2023.

The TeleDeputy Unit staffing plan allows up to 126 shifts per week and 504 workforce hours, and all Priority 3 and 4 calls for service that are eligible for TeleDeputy will be routed to the unit. During 2022, HCSO responded to 410,862 dispatched calls for service, with close to 60% of these calls being Priority 3 and 4, which generally do not require an on-scene law enforcement response. Managing these lower-priority calls for service remotely will allow patrol deputies to provide a faster response time to higher-priority 1 and 2 calls requiring an on-scene patrol investigation and should decrease response times to all priority levels of calls for service. The program is targeting a decrease of approximately 30% in response times to Priority 1 calls and 10-minute decreases in response times to Family Violence calls across all patrol districts. This reduction may impact homicide rates, as over 30% of cases investigated by the HCSO Homicide Unit in 2022 involved a Family Violence component. The HCSO will track response times to calls for service, the total number of calls and specific call types managed by the TeleDeputy Unit, and the number of reports and supplements generated.

Youth Diversion and Rehabilitation Services for Harris County Youth

The Youth Diversion Center, operated by the Harris Center for Mental Health and Intellectual and Developmental Disabilities, serves as an alternative to juvenile detention for Harris County youths ages 13-17, who have committed low-level, non-violent offenses and temporarily need respite care due to a behavioral health crisis. Offenses qualifying for diversion are determined by the Harris County Juvenile Probation Department and the District Attorney’s Office. The Youth Diversion Center provides clients with comprehensive rehabilitation services in a safe, supportive environment with crisis intervention, family counseling, and reintegration services included during their stay.

This rehabilitation program diverts youths out of the criminal justice system and helps them to learn new skills and be able to successfully transition back into their communities. A team of trained professionals, including psychiatrists, mental health counselors, care coordinators, nurses, and peer navigators, will work with children and their families at the center to develop individualized diversion plans. The length of stay for most children averages around 10 days, and clients receive frequent assessments to determine when they are ready to leave the center. To further promote enduring success and prevent recidivism, youths are connected to long-term behavioral health services within the community. The Youth Diversion Center’s wraparound services will impact around at least 700 cumulative unduplicated youth throughout program implementation.

The Behavioral Health Workforce Program Overview

In Harris County, the need for mental health and substance use services is greater than our existing behavioral health workforce can provide. It was reported that in 2018, there was one provider for every 920 residents in Harris County. This imbalance became greater during the pandemic, which also highlighted the need for practitioners skilled in navigating trauma and grief. Additionally, the current behavioral health workforce does not reflect the racial, cultural, and linguistic diversity of our region.

The Behavioral Health Workforce program is designated to expand the supply of qualified behavioral health providers and further develop current practitioners, increase the number of culturally and linguistically competent providers, and expand access to care. Initiatives address the full lifecycle of workforce development, from educating high school students about behavioral health careers and providing externship opportunities, to providing scholarships for college and graduate students, supporting licensing costs, and offering ongoing training. Providing school- and community-based clinicians with education about trauma- and grief-informed practices further enhances our ability to meet community needs.

The ARPA Behavioral Health Counseling Overview

The ARPA Behavioral Health Counseling for Youth and Families Program was created to increase access to behavioral healthcare services within schools and/or neighborhoods located in socially vulnerable areas within Harris County. The program aims to increase the capacity of community-based organizations and non-profits in the identification and treatment of behavioral health needs in school-aged youths and their families, increase provision of school-based mental health services, and reduce barriers in accessing treatment through integration of services into primary care and community-based settings.

Overdose Prevention and Substance Use Treatment Services

The ARPA Behavioral Health Substance Abuse Treatment and Overdose Prevention program was created to enhance and expand overdose prevention efforts and increase access to substance use treatment services. The rate of overdoses rose during the COVID-19 pandemic, and the lack of access to treatment has further exacerbated challenges for people dealing with the use of alcohol, fentanyl, cocaine, and other drugs in finding their path to recovery. This program improves access to care and increases community-based prevention efforts through substance use screenings, MAT services, enhanced care coordination efforts, community education, as well as integrated behavioral health services.

Community Mental Health Support and Outreach (HMHC)

The number of individuals reporting mental health difficulties increased during the COVID-19 pandemic. Low- income communities with pre-existing factors affecting mental health are likely to be at risk and often do not have access to necessary care. Healthy Minds, Healthy Communities (HMHC) is a Community Initiated Care (CIC) program with the goal of strengthening community behavioral health and resiliency. The program identified 10 key neighborhoods, which are largely communities of color disproportionately impacted by COVID-19, with high rates of poverty, increases in suicide, and barriers to behavioral health services. The program identifies community touchpoints and conducts outreach to raise awareness of mental health and treatment options, offers community-based trainings, and establishes support groups for survivors of suicide loss. The purpose of these tools and trainings is for community members to be able to support each other in times of emotional need.

Clean Streets, Safe Neighborhoods: Safety and Infrastructure Improvements

Clean Streets, Safe Neighborhoods is a crime prevention and neighborhood safety program that uses data to target Harris County neighborhoods where underinvestment in neighborhood infrastructure could be driving violent crime. The program aims to improve street lighting, sidewalks, and green spaces, and create opportunities for civic artwork. A Neighborhood Prioritization Index was utilized to identify priority communities based on the Center for Disease Control and Prevention’s Social Vulnerability Index, violent crime indicators, and infrastructure indicators. Several of the projects within the priority neighborhoods were identified based on surveys and studies gathering feedback from the community regarding neighborhood improvement initiatives. These studies identified areas with high pedestrian traffic and few sidewalks, poorly lit sidewalks and pedestrian paths, areas of high temperatures, and many other areas for neighborhood improvements. Harris County Precincts are working with the Engineering Department to coordinate on program design, construction, and maintenance plans.

The ARPA Neighborhood Nuisance Abatement (NNA) Overview

The ARPA Neighborhood Nuisance Abatement (NNA) project has been established to complement current NNA efforts in Harris County being implemented by the Harris County Public Health Department (HCPH). NNA is an initiative focused on reducing crime and improving public health in Harris County’s most impacted communities. The program aims to decrease crime and improve public health through proactive efforts, such as securing or demolishing unsafe structures, removing rubbish, securing abandoned pools, removing weeds to prevent pest infestation, and other abatement efforts. Through the abatement of these nuisances, the program will improve the social and environmental conditions of the community, reduce blight, and positively impact community health and development.

NNA targets existing nuisance properties in areas of highest need based on the Center for Disease Control and Prevention’s Social Vulnerability Index, homicide rates, and aggravated assault rates. Additionally, NNA works with stakeholders to identify unreported nuisances in the community.

ACCESS Harris County: Coordinated Care and Support Services

Accessing Coordinated Care and Empowering Self Sufficiency (ACCESS) Harris County is an integrated care model that addresses the root causes of poor health and life outcomes by holistically addressing the social determinants of health. Using a coordinated care approach, ACCESS Harris improves the health, well-being, sustained recovery, and self-sufficiency of the County’s most vulnerable residents by not just focusing on guiding them into the social safety net, but also enabling them to get out of it. ACCESS Harris focuses on delivering intensive wraparound services to individuals in need across the County through a no-wrong-door approach. This safety net includes providers that organize and deliver a significant level of health care and other needed services to uninsured, Medicaid, and other vulnerable patients.

Frontline staff improve the service delivery experience by working collaboratively to provide holistic, individualized wraparound services to patients. Without the ACCESS approach, these vulnerable populations could encounter challenges navigating a fragmented system with limited success. The initiative supports five cohorts: adults and youths participating in violence prevention programs, new and expectant mothers, homeless individuals with physical and behavioral health conditions, re-entry populations, and residents with chronic health conditions.

Emergency Nursing Staffing Program for Hospital Surge Support

Harris County’s Emergency Nursing project supported an increase in medical workforce staffing levels in local hospitals to address surges in COVID-19 cases associated with the Omicron and Delta variants and provided critical support to patients and healthcare workers. COVID-19 created a strain on hospitals in disproportionately impacted areas, and during both the Delta and Omicron wave, hospitals across Texas struggled with historically low staffing levels.

Harris County Public Health collaborated with Angel Staffing and the SouthEast Texas Regional Advisory Council (SETRAC) to place healthcare staff in area hospitals. SETRAC specifically worked to identify hospital needs to prioritize and place staff based on those needs. Angel Staffing recruited and placed emergency medical staff in area hospitals and managed the associated payroll. Through these services, registered nurses, respiratory therapists, and other medical staff were supplied to hospitals across the County, with a particular focus on Intensive Care Units (ICU), medical surge/trauma, emergency department, respiratory specialists, pediatric ICU, and pediatric medical surge staffing. In total, 963 registered nurses and respiratory specialists were placed across 18 hospitals. Harris County received a FEMA reimbursement on the funds spent supporting non-profit hospitals in Harris County in September 2022.

Incentives to Increase COVID-19 Vaccination Rates

To counter high COVID-19 vaccine hesitancy, this program authorized the provision of $100 payment incentives, per recipient, for a first dose of a COVID-19 vaccine. Providing these incentives was helpful to communities facing access barriers, such as concerns about taking time off from work or the cost of transportation to a vaccination site. This program was open to all Harris County residents.

The Harris County Office of County Administration and Harris County Public Health partnered with Blackhawk, USIO, and HEB to provide gift cards to support additional incentivization for this program. Harris County Public Health distributed the gift cards and tracked vaccination rates by demographic variables and changes in vaccination rates relative to the surrounding counties. A Rice University report found that several zip codes where vaccinations were highly needed saw an increase in vaccinations after the incentives were announced. Compared to trends in surrounding counties, an estimated 30,000 incremental vaccines were provided as a result of the incentive.

The Lead Abatement and Prevention Program Overview

The Lead Abatement and Prevention program mitigates lead poisoning in Harris County by assisting in the abatement of lead-based paint hazards in child-occupied facilities and owner- or renter-occupied, single-family housing units for the purpose of providing safe and decent housing for low- and moderate-income households. Additionally, the program is committed to reducing lead poisoning in at-risk individuals, including pregnant women and children under the age of six years old in communities throughout Harris County. Lead poisoning caused by elevated blood lead levels (EBLLs) is a serious but preventable health threat to both children and adults in the United States. Primary (education) and secondary (lead screening) prevention of lead exposure is the most effective approach to reducing the risk of lead poisoning in children. The abatement program focuses on residential buildings and child-occupied facilities, like daycares and preschools, constructed before 1978. The Lead Abatement and Prevention Program operates mobile testing sites at schools and community events to increase testing among pregnant women and children under the age of six. Mobile testing sites increase awareness of lead poisoning and address concerns about access to transportation to testing sites in impacted communities.

The program aims to increase the number of home lead abatements, provide blood level tests, and provide lead screenings and education to at-risk individuals. The program tracks the number of outreach events, the number of children and pregnant women tested, the number of assessments of homes and child-occupied facilities, and the number of facilities abated. The goals of this program are to reduce exposure to lead, improve health outcomes, enhance quality of life, and increase awareness of lead concerns.

Maternal and Child Health (MCH) Program Overview and Services

The Maternal and Child Health (MCH) pilot program was developed to lessen the health disparities that impact Black women and their babies by increasing their ability to access and utilize quality care. The program provides direct assistance to at-risk, expecting families with a holistic approach to prenatal care, postpartum care, and infant-early child development. Working closely with a broad and diverse group of community partners, expecting families will have access to local organizations and programs specializing in maternal and child health. The program allows more Black mothers and their infants to enroll in available health coverage options, provides them with access to more prenatal and well-child visits, and provides home visits from educators and healthcare providers.

Community Health Coordinators and Licensed Social Workers conduct home visits, using the Healthy Families America (HFA) approach to support families as they navigate their parenting journey. HFA is an evidence-based home visitation model rooted in the belief that early, nurturing relationships are the foundation for life-long, healthy development. HFA offers research-based curriculums to guide the team members and encourages local sites to implement additional services to further address the specific needs of the target populations.

Reproductive Healthcare Access Fund (RHAF) Overview and Funding

The Harris County Reproductive Healthcare Access Fund (RHAF) provides funding to existing under-resourced health clinics and grassroots organizations to decrease the transmission of sexually transmitted infections (STI); improve the overall health of people of reproductive age; and increase clinical services within Harris County zip codes with the highest SVI and uninsured rates. The fund aims to expand services and improve reproductive healthcare access in priority zip codes, increase utilization, and build capacity for reproductive healthcare organizations to educate, promote, and connect the community to reproductive healthcare services. This funding opportunity specifically targets entities at the local level to build on existing expertise and create sustainable operational improvements. The Harris County service area will also increase reproductive healthcare access by including service provision to uninsured residents at new clinics or mobile units.

The Chronic Disease Prevention (CDP) Program Overview

The Chronic Disease Prevention (CDP) program is expanding programming and education to reduce the prevalence and impact of chronic disease-causing risk behaviors in Harris County. This includes offering clinical services, education on tobacco and vaping prevention and cessation, nutrition and physical activity, diabetes prevention, and community incentives.

The mission of this program is to improve the quality of life for Harris County residents while reducing the number of chronic disease-related deaths through targeted and long-term action plans. The CDP program partners with local schools, community centers, and other community-based programs to provide class-based curriculums for Harris County residents to provide information and resources about the risks associated with common chronic diseases as well as strategies for prevention.

FoodRx Program for Food Access and Health Support

Harris Health’s FoodRx program proactively embeds a population health approach as part of the standard of care for chronic disease management, strategically intervening with patients with expressed social needs and known health risks in order to improve their health outcomes. The program addresses health-related social needs—like food insecurity, poor nutritional knowledge, and lack of access to culinary education—that are prevalent in vulnerable populations and tied to poor health outcomes. Harris Health’s Food Farmacies are currently at two family practice clinics and the LBJ Hospital. With ARPA funds, this program will expand with three in-clinic Food Farmacies and two community redemption sites. The Food Rx program serves adult patients expressing food insecurity and provides a more intensive intervention for those with Type 2 diabetes. Patients who screen positive for food insecurity meet with a community health worker, select a variety of healthy foods with a dietitian, are connected to a Houston Food Bank navigator for benefits enrollment, and are linked to community food resources. Patients with severe diabetes are invited to participate in a nine-month "walk and learn" program that helps them learn to better manage their diabetes and enroll in the University of Texas School of Public Health’s co-located culinary medicine curriculum, which teaches patients the skills to make delicious, healthy, low-cost, and culturally relevant meals. Graduation from the Food Rx program includes curated linkages to community supports at accessible locations near and within the patient’s community.

Gastroenterology Lab Expansion and Colorectal Cancer Screening Access

Harris Health’s existing gastroenterology labs are at maximum capacity, and Harris Health maintains a significant number of patients waiting for colonoscopy procedures at any given time. Delays in diagnosis can result in poor outcomes of an otherwise treatable cancer. Ultimately, it is the goal of Harris Health to reduce the number of colorectal cancer diagnoses through prevention, and to reduce the severity of colorectal cancer diagnoses. Colorectal cancer disproportionately affects the Black community, as they are approximately 20% more likely to get colorectal cancer and about 40% more likely to die from it than most other groups. Further, there are cultural barriers that make it less likely for Black communities to get screened for colorectal cancer. This program now allows Harris Health to open an outpatient gastroenterology lab at Quentin Mease Health Center and create additional capacity for colonoscopy procedures. The new lab will increase availability of appointments and will be located directly on a bus route, making access easier and minimizing transportation burdens for those patients without a personal vehicle.

Community COVID Housing Program (CCHP) Overview and Services

In response to the COVID-19 pandemic, state and local public systems implemented a variety of public health strategies to mitigate further exposure and slow the spread of the virus. Due to underlying health conditions and a lack of access to facilities, individuals experiencing homelessness have a higher susceptibility and are at greater risk of experiencing severe symptoms. Per the Centers for Disease Control and Prevention (CDC) and the Department of Housing and Urban Development (HUD), special, strategic endeavors are required to protect people experiencing homelessness. Given the urgency of the COVID-19 crisis and the imminent threat to the public health and safety of the homeless population, the urgency for a coordinated and large-scale homeless housing initiative was needed to help prevent the spread of infection amongst this highly susceptible population. The Community COVID Housing Program (CCHP) was designed with the goal of scaling permanent and long- lasting approaches and interventions that have demonstrated success in reducing homeless populations. It also aims to reduce the amount of time that an individual experiences homelessness, increase permanent housing options, and decrease encampments. CCHP provides a strategy that not only responds to the crisis of the pandemic but also strategically utilizes federal funding to reduce homelessness and further save lives. CCHP does this in several ways:

  • Permanent Supportive Housing (PSH) is an intervention combining affordable housing assistance with voluntary support services to address the needs of chronically homeless people and other homeless individuals with high barriers. Services are designed to build independent living and tenancy skills and connect people with community-based health care, treatment, and employment services.
  • Rapid Re-Housing (RRH) provides short-term rental assistance and services for up to 12 months. The goals are to help those experiencing homelessness obtain housing quickly, increase self-sufficiency, and stay housed. Assistance is offered without preconditions (such as employment, income, or sobriety) with the resources and services provided tailored to the needs of the individual.
  • Diversion includes housing-focused problem solving, mediation, and conflict resolution conversations paired with limited financial assistance offered to persons seeking emergency shelter or residing in emergency shelters.
  • Essential Client Support Services are specialized programs assisting people experiencing homelessness. This includes a range of services provided to assist and support individuals in developing skills to gain access to needed medical and behavioral health, housing, employment, and social, educational, and other essential human services.
  • Navigation includes the process of assisting individuals from the point of the housing referral until the date of move-in to housing. Navigators provide housing search and placement to all program participants.

Employ2Empower (E2E) Overview

Employ2Empower (E2E) is a county-wide, employment-first model that connects participants with a viable path to a healthy, productive, and economically stable future. The E2E program helps the unhoused and those living in encampments to reenter the workforce and utilize wraparound services. The program aims to provide a low barrier for participants to gain employment, along with access to social services, such as housing navigation, healthcare, and income support, with the goal of connecting participants to a pathway to permanent housing solutions.

E2E aims to complement the current system for finding housing and other resources for the homeless but differs in the way it engages with workers. The program’s unique hourly rate incentive encourages people in need of housing to regularly engage with support workers, making it easier to connect them with resources and track housing applications. It also makes it easier for them to return to work and gives them specialized skills in a forgiving, supportive environment. The crew works three days in the field and on the fourth day they receive resources such as housing services, workforce training, and personal development coaching. Participants earn money by completing community development projects such as graffiti abatement, illegal dumping abatement, landscaping, and maintenance of public and County-owned properties.

HAY Center Campus Overview and Funding

The HAY Center Campus will serve homeless youth and young adults who have aged out of the foster care system and are at or below 50% area median income (AMI). The campus will feature a 17,000-sq-ft wraparound services building with offices, meeting rooms, a computer lab, and life skills training rooms, as well as a 41,000 square foot residential building with 50 apartments, community space, a kitchen, a small gym, a business center, and private study rooms.

Initial funding sources for the campus included $20 million in Harris County CDBG-DR funds, $5 million in City of Houston CDBG-DR funds, and $5 million in philanthropic funding, in-kind donations, and Harris County general funds. With construction costs rising significantly from project inception to groundbreaking, $9 million in Harris County ARPA Local Fiscal Recovery Funds provide a key bridge allowing the project to continue in the face of inflation.

Women’s Empowerment Center (WEC) Mission and Services

The Women’s Empowerment Center’s (WEC) core mission is to address the needs of women housed in the jail facility and successfully prepare them for transition out of the criminal justice system through connection to services during and after incarceration. The WEC provides women in custody with intensive, individualized case management and productively engages them in a robust series of programming opportunities and wraparound services designed to meet their unique needs. ACCESS Harris provides early intervention intensive programming and case management for the women in the facility and works in partnership with the HCSO staff to ensure the successful execution of re-entry support and services. The supportive services offered by HCSO and ACCESS Harris aim to provide a holistic approach to coordinated care to meet the needs of the women. This solution allows members of coordinated care teams to deploy an interdisciplinary response to bring together different safety-net service departments and provide a complete picture of a participant’s health, track service provision and progress towards goals, and coordinate discharge and aftercare planning when individuals return to their communities. The WEC represents a shift away from a detention-focused corrections model and towards a more rehabilitative, gender-responsive, and trauma- informed approach that reduces harm, improves stability, and lowers recidivism.

Multi-Family Development Program Overview

The Multi-Family Development program provides funds for the acquisition, rehabilitation, reconstruction, and new construction of affordable multi-family housing projects in Harris County. For each of these developments, Harris County will impose new deed restrictions that extend the tenant income restrictions, rent limits, and period of affordability for at least 20 years for properties acquired. The affordable rental units created or preserved by the program will be restricted to low- to moderate-income (LMI) residents. The program will increase the affordable housing stock in Harris County and provide more options for renters.

Single-Family Rehabilitation Program Overview

The Single-Family Rehabilitation Program will be administered by the HCD with community-based non-profits serving as subrecipients who will deliver program services. This program has been designed to preserve affordable single-family housing owned by LMI households residing in Harris County by providing funds for specific rehabilitation services for single-family homes.

The program will focus on the following rehabilitation categories:

  • Repair or replacement of roof (shingles and decking only)
  • Repair or replacement of air conditioning/furnace unit and related components
  • Repair or replacement of water heater
  • Replacement or installation of freestanding, major appliances (refrigerator, stove, dishwasher, washing machine and/or dryer)
  • Accessibility modifications (repair or installation of exterior ramp and/or exterior lift)
  • Security improvements (replacement of front door, back door and/or deadbolts; replacement of broken windowpanes; repair, replacement, or installation of window locks)
  • Basic health and safety improvements (replacement or installation of smoke alarms and carbon monoxide detectors)

The program provides funding per project so that unsafe and uninhabitable homes can be reconstructed into hazard-resilient and energy-efficient homes that preserve an LMI homeowner’s ability to remain in their neighborhood of choice. The program also provides funding for relocation of the homeowner so that they can be safely housed during the reconstruction process.

ARPA Single-Family Housing Programs Overview

HCD will utilize a two-pronged approach to administer the ARPA Single Family Acquisition/Development and Resale Program. All three programs will utilize the Community Trust Model to create affordable housing for low-income households.

The three programs include the following:

  • The Acquisition and Resale program: HCD acquires primarily newly constructed single-family homes located in Harris County and resales those homes to eligible low-income households.
  • The Homebuyer Driven Program: HCD assists low-income homebuyers in acquiring a newly constructed home by providing a maximum of $150,000 in financial assistance toward the purchase of a home.

Single-Family Reconstruction Program Overview

The Single-Family Reconstruction Program will be solely administered by HCD to provide funding for the preservation of affordable single-family housing owned by LMI households residing in Harris County. This program has been designed to preserve affordable housing through the reconstruction of unsafe and uninhabitable homes into hazard-resilient and energy efficient quality homes. The preservation of owner- occupied affordable housing allows LMI homeowners the ability to remain in their familiar neighborhoods and communities.

COVID-19 Eviction Defense Program Overview

Harris County seeks to maximize the impact of its COVID-19 rental assistance funding by investing in eviction defense legal services for low-income residents. Harris County has had an increased number of evictions, especially for non-payment of rent due to household financial losses related to the COVID-19 pandemic. Housing instability has lasting negative health and financial impacts on the families losing their homes as well as their communities. During the public health crisis and aftermath, the COVID-19 Eviction Defense Program will continue to support a network of housing legal service providers to meet increased demand through funding for attorneys, paralegals, intake staff, interpretation, community outreach, and programmatic costs associated with these services as well as those costs necessary to ensure the provision of this legal assistance safely in light of the public health and economic crisis.

As the nation continues to recover from the COVID-19 pandemic, the U.S. is facing an eviction crisis. Eviction filings in Harris County are above the pre-pandemic average: From January through July 2022, landlords filed 121,248 evictions; and tenants were represented by an attorney in only 1.96% of those cases. In one week in August 2022 alone, Justice courts scheduled 1,865 eviction hearings. These figures do not include informal evictions, in which families self-evict before receiving a formal notice of a court setting. The program makes short-term, non-cash, in-kind emergency disaster relief in the form of consulting, referral, legal, and other related legal services directed to cure legal needs due to COVID-19 for qualifying applicants in Harris County, Texas. This program will further the objectives of the County and serve the broader purpose of protecting the health, safety, and economic welfare of Harris County residents.

ARPA Wastewater Infrastructure Project Overview

The ARPA Wastewater Infrastructure project aims to increase access to functional sewer systems, particularly in vulnerable communities where minimizing environmental and public health impacts of septic system failure is critical. Insufficient access to reliable sewage infrastructure compromises general health and contributes to the spreading of contagious diseases, and decentralized systems in low-income areas have higher rates of failure, leading to polluted and compromised water sources.

The Harris County Engineering Department is investing $37.6 million in ARPA funding to provide public wastewater infrastructure to Westfield Estates, a high-density, low-income neighborhood consisting of older homes. Homes in this subdivision currently rely on outdated septic systems for wastewater services, which have a 46% septic failure rate and can discharge raw sewage into yards, then into the roadside open ditches, and into Halls Bayou, which is an impaired waterway.

ARPA funds are being used for a feasibility study, program management services, property acquisition, construction of a sanitary sewer system and wastewater treatment facility, materials testing, and Harris County Engineering Department labor. Constructing a public sanitary sewer system and abandoning septic tanks will help minimize bacterial contamination in the subdivision and waterways. Access to wastewater services also has the potential to increase development within the area. When completed, the new system will deliver safer, more reliable wastewater services to over 700 homes.

Community Facilities & Infrastructure Investments Program Overview

The Community Facilities & Infrastructure Investments program seeks to utilize ARPA funding for community facilities, infrastructure investments, and public services to increase the operational capacity of nonprofit organizations and local governments programs. Investments will prioritize improving the lives of county residents through:

  • Reducing the number of residents experiencing homelessness, housing insecurity, or food insecurity
  • Expanding access to behavioral health supports
  • Expanding access to healthcare
  • Reducing violent crime and domestic violence or sexual abuse

Funding will be distributed equally for projects across the four Harris County Precincts.

Small Business Relief Fund Overview

Harris County created the $30 million Harris County Business Relief Fund to accelerate recovery for microenterprises and small businesses impacted by the COVID-19 pandemic. The fund provided grants ranging from $5,000 to $25,000 to eligible microenterprises and small businesses located inside Harris County. LiftFund, a Texas Community Development Financial Institution (CDFI) with over 25 years of experience serving small and underserved entrepreneurs, administered the program and coordinated outreach through 90 community partners and five navigator agencies. Use of grant funds was restricted to business-related expenses including payroll, working capital, business rent, inventory, supplies, equipment, and other operating costs.

Harris Hub Overview

Harris Hub will provide funding to Business Support Organizations (BSOs) to increase their capacity to provide in-depth and culturally competent technical assistance to small and micro businesses affected by the pandemic, with a focus on Minority- or Women-owned Business Enterprises (M/WBE) and business owners in Qualified Census Tracts (QCTs) as designated by the U.S. Department of Housing and Urban Development (HUD).

Minority and Women-Owned Business (MWBE) Disparity Study Fund

To support educational institutions in developing inclusive procurement practices, Harris County created a fund for community colleges and Independent School Districts to conduct disparity studies regarding the utilization of Minority and Women-Owned Business Enterprises (M/WBE). The goal of this fund is to encourage the mitigation of racial and gender disparities where they may exist in public procurement practices, decrease barriers often experienced by MWBEs in contract procurement, and increase access to economic opportunities.

Apprenticeship Advantage Overview

Apprenticeship Advantage promotes the apprenticeship model of workforce development, which includes on- the-job training and early job placement in partnership with employers. Program goals include creating and expanding opportunities for U.S. Department of Labor Registered Apprenticeship Programs (RAPs) in traditional and high-growth emerging industries within Harris County. Apprenticeship Advantage develops the Harris County workforce while fostering access to apprenticeship opportunities for underemployed and unemployed residents, dislocated workers, opportunity youth, people of color, women, and those without college degrees. This program responds to the COVID-19 public health emergency’s economic impact on Harris County workers, including disproportionate challenges for those without living wage jobs.

Complementing training opportunities, wraparound support services included in the program increase apprenticeship retention, completion, and job placement rates. The program includes apprenticeships for in- demand technical skills, supports the energy transition with green jobs such as low-emission vehicle repair, and features the first-ever International Alliance of Theatrical Stage Employees (IATSE) apprenticeship for sports and entertainment sector employees.

Apprenticeship Advantage is administered by two subrecipients, the Texas Gulf Coast Area Labor Federation and NPower. The Texas Gulf Coast Area Labor Federation will provide pre-apprenticeship and apprenticeship training across 10 union trades, and NPower will provide apprenticeship training and job placement in digital skills careers, including cybersecurity.

Hire Up Harris Overview

Hire Up Harris supports comprehensive approaches to workforce development characterized by training complemented by soft skills development, professional skills development, and wraparound services. The goals of this program include the promotion of skills training and wraparound support services that can lift target populations — underemployed, unemployed, dislocated workers, opportunity youth, people of color, women, and those without college degrees — from poverty and economic insecurity. Harris County also seeks to build capacity among organizations that provide workforce training. Importantly, this program aims to support programming that includes wraparound support services that increase apprenticeship program completion, placement rates, and retention rates.

Hire Up Harris is administered by two subrecipient vendors, Wesley Community Center and Volunteers of America Texas.

Child Tax Credit (CTC) Outreach and Assistance Program Overview

According to the IRS, the Child Tax Credit (CTC) has not been claimed for at least 30,000 children in Harris County, representing over $90 million in missed payments. To combat child poverty and help eligible families claim the credit, Commissioners Court approved a $0.5 million contract with BakerRipley for community outreach, non-filer form preparation assistance, and tax preparation assistance. The program's main goal is to ensure the low-income families at risk of missing out enroll in the 2021 expanded CTC, which could lead to a significant decline in child poverty. Through the reporting period, 3,189 children have been claimed under the CTC as a result of outreach and assistance efforts, and 6,175 households have filed taxes as a result of assistance. Populations that were targeted for outreach included extremely low-income families, households with low education levels, disabilities, or limited internet access, and mixed immigration status households. To measure the impact of this program, BakerRipley is tracking metrics on households that receive information about the CTC, the number of households accessing the CTC non-filer portal as a result of assistance, the number of households filing taxes as a result of assistance, the number of children claimed under the CTC as a result of outreach and assistance, and other key metrics on tax-related services accessed. While difficult to measure, increased uptake of the CTC will help to combat child poverty across the County.

Neighborhood Tax Centers (NTC) Program Overview

Through Harris County's three-year investment in tax preparation assistance, the BakerRipley Neighborhood Tax Centers (NTC) program will help more than 40,000 families prepare tax returns, capture EITC and CTC, and secure ITINs, expanding reach through 12 mobile tax assistance sites. This investment will return around $70 million in net refunds to Harris County families and save an estimated $10 million in tax preparation fees. Funds will be exclusively used for direct staff costs for tax preparation, program communications, and outreach. Populations served include extremely low-income families, households with low education levels, disabilities, or limited internet access, and mixed immigration status households. To measure the impact of this program, BakerRipley is tracking households that receive information about tax assistance, the number of households filing taxes as a result of assistance, net refunds captured, ITINs secured, and other key metrics on tax-related activities.

Harris County Recovery Assistance (HCRA) Program Overview

In 2021, Harris County and Catholic Charities partnered to administer a total of $60 million in financial assistance to Harris County residents in response to the financial distress caused by the COVID-19 pandemic as part of the Harris County Recovery Assistance (HCRA) program. The program provided a one-time cash transfer of $1,500 to households located within Harris County that met eligibility requirements such as having at least one household member enrolled in a public assistance program, or a total household income at or below 60% of the U.S. Department of Housing and Urban Development (HUD) Area Median Family Income. Recipients were allowed to use the payment for any COVID-related emergency expenses such as healthcare, rent or mortgage, utilities, food, internet, transportation, child care, and other past-due expenses.

Immigration Legal Services Program Overview

This program provides immigration legal services and naturalization support to Harris County residents over three-year period. It will ensure an inclusive and equitable recovery to the COVID-19 pandemic, with long-term benefits for economic and social outcomes.

This program meets the requirements for ARPA fund use: there is a pre-existing harm for a vulnerable group, which was exacerbated by the pandemic, and the proposed program responds to and is proportional to the harm. It would also further Harris County’s commitment to equity, giving immigrants the opportunity to participate fully in civic and economic life by gaining lawful immigration status with the assistance of free immigration counsel.

Community Prosperity Program (CPP) Overview

The Harris County Community Prosperity Program (CPP) is a flexible financial stability initiative designed to support 1,850 families in Harris County. Developed in response to the COVID-19 pandemic, which highlighted long-standing health and economic inequities, the program is funded by a $20.8 million investment from the American Rescue Plan Act (ARPA).  

The pandemic and economic fallout highlighted the financial challenges for low-income families, many of whom are just a paycheck away from losing their home or vehicle or being able to cover a financial emergency. More than 200,000 Harris County workers in the region (8.6% of the workforce) are considered “working poor,” with at least one job but an income level below the federal poverty line. With low-wage industries continuing to grow, there is a significant risk that the working poor population will increase, particularly among Hispanic and Black workers, contributing to income inequality in the region. The lack of jobs with a living wage, paired with an increase in the cost of living, has caused many households to struggle to make ends meet.  

The Harris County Community Prosperity Program is designed to address economic inequality and provide financial security to residents through monthly $500 direct debit transfers. The program aims to enhance financial stability, promote self-sufficiency, increase employment opportunities, improve housing and financial stability, and support the physical and mental well-being of participants. 

The program will serve two distinct cohorts. The first cohort includes residents who live within the top 10 high-poverty zip codes in Harris County. The second cohort includes priority populations under ACCESS, a coordinated and client-centered safety net service delivery model administered by Harris County Public Health.  

To ensure transparency and accountability, the program monitors spending categories, ensuring funds are used to meet basic needs and contribute to the long-term prosperity of the community. 

Early REACH Program Overview

Early REACH (Raising Educational Access for Children in Harris County) programming works with high-quality child-care centers to add 800-1,000 new child-care slots that are in, or near, child care deserts and have a high social vulnerability index. This is a pilot program using a contracted slots model to increase providers’ capacity to provide high-quality child care. The focus is on children with the least access to care: infants, toddlers, and three-year-olds, families with low incomes, and families in high-poverty areas. Additionally, Early REACH will assist the staffing of child-care environments by requiring a living wage for classroom staff and supporting good working conditions to reduce teacher turnover. Early REACH also creates strong, durable small businesses by building entrepreneurial practices to support the sustainability of child care.

County Connections Youth Summer Initiative Overview

County Connections Youth Summer Initiative will provide grants to organizations that offer comprehensive summer programming, short-term projects, and other enrichment for children ages 5-18 through The Harris County Department of Education (HCDE) Center for Afterschool Summer and Enrichment (CASE) for Kids. County Connections fills gaps in existing enrichment services for youth, sponsors full and partial scholarships to assist families with program fees, and includes college and career readiness initiatives for older children. During the height of the COVID-19 pandemic, grantees provided direct service activities, virtual learning activities, or hybrid lessons. This program aims to ensure accessibility and meet the health and safety guidelines related to COVID-19 to provide children with enriching activities they did not have during the pandemic.

Early Childhood Research and Data Insights

The Rapid Assessment of Pandemic Impact on Development – Early Childhood (RAPID – EC), administered by Stanford University, is utilized to collect information on the following of families with children under 5:

  • Families’ needs in relation to child care and healthcare
  • Families’ needs in relation to impacts of COVID-19
  • Mental health and wellbeing of parents and children
  • Material hardships for families before and during the COVID-19 pandemic

The University of Houston Institute for Research on Gender, Women and Sexuality (UH-IRGWS) was selected to administer the RAPID EC-Survey. Over two years, UH-IRGWS, in collaboration with Harris County and Stanford University, will conduct the RAPID EC-Survey across Harris County, gather data and report on research findings. Program results will be used to help direct the County’s American Rescue Plan Act (ARPA) investments and inform regional strategy.

The Home-Based Child care Providers in Harris County Report was funded by a planning grant from Home Grown, an organization focused on supporting home-based child care providers and produced by Connective. It included direct outreach to home-based child care providers, including Vietnamese, Spanish, and English-speaking providers, to learn what supports are needed by these providers.

Child Care Subsidy Process Improvement Overview

Harris County and the City of Houston established a working group of child care providers and other key stakeholders to advise on their investments entitled, Child Care Subsidy Process Improvement. A key investment area established by this working group was the need to improve the current enrollment system for the Gulf Coast child care subsidy program. This program is the only public funding available to support family’s ability to quality child care. PFM Group Consulting LLC proposed a four-month engagement to deliver an analysis of the current state of the enrollment system for the Gulf Coast child care subsidy program, which is administered by Gulf Coast Workforce Board, as well as an articulation of how the board can improve upon its current system.

Alliance Home-Based Child Care (HBCC) program Overview

The Alliance Home-Based Child Care (HBCC) program aims to close the child-care gap in Harris County by providing professional child-care training, business development, and instruction services for entrepreneurs, specifically targeting refugee women as child-care providers. The key priorities for The Alliance are to connect refugee communities, close the child-care gap for low- to moderate-income populations, provide opportunities to increase household incomes and allow parents and/or other caregivers to enter the workforce with safe and consistent child care.

The Alliance HBCC supports eligible refugee women to establish licensed home-based child-care businesses throughout Harris County. With ARPA funding, they are expanding their client and train services with the goal to add 1,103 child care slots for 75 new child care providers over three years.

Safe Babies Program Overview

Safe Babies is an initiative implemented by First3Years, which works to promote secure attachments for infants and toddlers in foster care with positive collaboration between birth and foster parents and supporting reunification staff and stakeholders at every level of the foster care system.

Their initiatives include working directly with birth families and foster families to strengthen relationships and facilitating broader systemic changes for a developmentally informed child welfare system so all children receive the level of care necessary to thrive. Safe Babies supports children, birth and foster families, early childhood professionals, stakeholders, and child welfare staff across Houston and Harris County. Their work is linked to COVID-19 as one of many solutions to support birth and foster families that may be affected by parental stressors due to school closures, high rates of unemployment, rising food costs, and lack of quality child care in their communities.

upWORDS Program Overview

The upWORDS program is a 15-week early language development program offered universally to families with children 0-3 years of age. It is a part of the upWORDS Community Model, a tiered framework in which universal and targeted interventions work in tandem to achieve goals of supporting early brain development and reducing developmental disparities in Harris County. The Community Model also provides training to 6,000 professionals who work with young children on topics including early brain and language development and positive parenting. Their initiatives include language development programs, home visitation for new moms, developmental pediatrics for identified children, programming for children exhibiting speech and language delays, extended parent training, care coordination, training for early care professionals, and providing families with kits containing educational resources.

Project Description

Collaborative for Children was chosen to expand its Centers of Excellence Program across Harris County. The purpose of Centers of Excellence (COE) is to create a cost-effective formula for statewide school readiness initiatives by providing a three-tier model of support and training for children, families, and child-care staff. Child-care centers in the Level 1 Model are the highest need, with 50% or more children receiving subsidies, and will obtain intense on-site and remote intervention along with a professional learning community and access to the Collab-Lab. The COE Level 2 Model provides services to centers that have less than 50% of children receiving subsidies and is more focused on teacher development, on-demand training, professional learning communities, and Collab-Lab visits. The COE Level 3 Model provides pop-up centers to shelters, apartment complexes, community parks, and large-scale events to connect families to resources that support social-emotional learning and STEAM activities.

Kids' Meals Overview

Kids’ Meals was chosen to expand the healthy meal delivery program to children and families in Harris County. The purpose of Kids’ Meals is to provide children relief from severe food insecurity and food deserts in poverty-stricken neighborhoods. The organization aims to end generational poverty by providing children with meals until they reach kindergarten, thus negating low school engagement, substandard academic development, and poor emotional and physical health. Kids’ Meals also delivers meals for every child in the home up to age 18 during the summer when most children don’t have access to food in school-based settings. A secondary component of Kids’ Meals is to distribute educational materials, essential information about vital wraparound services, and monthly newsletters which detail services and programs offered by collaborative social service partners.

Early Learning Quality Network Program Overview

Emerging research suggests that now, more than ever, children need support for their healthy learning and development. The COVID-19 pandemic’s impact on child development will not be known completely for many years, but emerging research suggests that infants born during the pandemic scored lower, on average, on tests of gross motor, fine motor, and communication skills compared with those born before it. Additionally, providers have noted delays in speech and language as well as trouble sharing and being in groups. The early care and learning community acknowledges that the pandemic has exacerbated housing and food insecurity as well as rising rates of neglect and household dysfunction.

Yet, at this urgent time for child development, there is less child care available to support young children than ever as a result of COVID-19. Research from Children at Risk indicates that approximately 25% of all child-care facilities closed statewide during the height of the pandemic and 20% of all available child-care capacity was lost. Communities of color were the most impacted by COVID-19-related closures. These communities experienced twice the rate of child-care disruptions and centers within these communities were twice as likely to close. In addition to the number of closures of programs overall, those seeking to reopen, including school- based programs, struggle to hire qualified staff to support young children because of the pandemic.

Additional support will be needed to build back this supply of qualified staff and ensure the adults working in early learning settings have the resources they need to thrive. One way Harris County is addressing this need is to create an Early Learning Quality Network. A quality network is comprised of two parts, a Quality Network Support Hub, and Local Network Organizations. The Quality Network Support Hub will provide planned and on-call supports for each Local Support Organization to accomplish its goals. These supports can include but are not limited to training and coaching on baseline definitions of quality, on materials and support to create community plans, and on access to experts in various aspects of the early childhood field. The Local Network Organizations will be housed at a community-based organization within a target community across Harris County. They will form an Advisory Group to guide their work, which will consist of child-care providers, families, education and health professionals, and other key stakeholders that represent that community. The Local Network Organization will hold community conversations to adopt a definition of quality for their community and identify key initiatives to support child care while building relationships. They will fund and oversee quality initiatives across all types of child care including center-based, home-based, and family and friends child care.

Shine Childhood Facilities Fund Overview

The SHINE Childhood Facilities Fund is Harris County’s first-ever facilities-specific funding for providers in the region to receive support for construction, remodeling, and expansion projects for the physical spaces in which they offer early learning and care. The SHINE Fund serves to increase providers/' access to capital and resources to make safe and nurturing environments for Harris County’s children. It also serves as a model to further examine the efficacy of offering providers access to funding pre-determined for altering their facilities, and in turn, its effects on children’s learning and growth.

This project is not yet in the implementation phase, but it has been designed to reach all Harris County Precincts. The SHINE Facilities Fund will prioritize areas within each Precinct with a High Social Vulnerability Index (SVI) and a low supply of quality child care, and will prioritize providers who serve or will begin to serve infants and toddlers of marginalized backgrounds (e.g., children with disabilities, low-income children, homeless children, and children in foster care).

Helping Hands Overview

Helping Hands aims to provide funding and support to community-based organizations in improving and increasing efforts to contact and inform likely eligible residents and enroll them in public benefits programs. The targeted public benefits programs for Helping Hands include Children's Medicaid, Children’s Health Insurance Program (CHIP), CHIP for pregnant women, Supplemental Nutrition Assistance Program (SNAP), and the Harris Health Financial Assistance Program. The program aims to enroll at least 1,000 residents in public benefits programs and build sustainable benefits enrollment capacity and knowledge among Harris County community-based organizations. The Alliance of Community Assistance Ministries (ACAM), the intermediary organization, will conduct a granting program to subrecipients to achieve the goal of Harris County Helping Hands.

Early Childhood Resiliency Fund Program Overview

The local Intimate Partner Violence (IPV) and Domestic Violence (DV) response network in Harris County contains a multitude of shelter-based and nonresidential interventions and programs aimed at supporting families experiencing DV and IPV. Further, there are approximately 325 families experiencing DV placed in publicly supported, affordable housing. This network is a key intervention point for reaching extremely vulnerable children with needed services. Harris County’s Early Childhood Initiatives is interested in supporting the DV and IPV response network, as well as aligned networks and programs, by responding to the developmental needs of young children in Harris County exposed to IPV and DV. The Early Childhood Resiliency Fund will help reduce the harmful developmental impacts of early exposure to violence by investing in trauma-informed programs and strategies for young children exposed to DV and IPV. Eligible families are families with young children that have been exposed to DV/IPV. The purpose of this program is to improve developmental outcomes for the eligible population. Progress towards the goal will be measured through various diagnostic batteries.

Project Description

Inspire will provide grants to qualifying families to promote community inclusion, prevent institutionalization, and improve developmental outcomes for young children. Progress on outcomes will be captured on several diagnostic batteries. Inspire participants can receive up to $5,000 in financial assistance for assistive technology, learning materials, and/or services directly related to the disability, plus $1,000 for respite care (apx. 100 hours). It is estimated that 250 Harris County residents will receive a grant each year (500 unduplicated within the 24-month contract term). Qualification for Inspire includes, being a Harris County resident between the ages of 0 – 6 years, meet low income requirement of 200% below Federal Poverty Level (FPL) guidelines (income determination made based on parent or legally authorized representative), have a developmental delay, IDD, or pervasive developmental disorder, live in a natural/family home (excludes residential settings providing room/board, intermediate care facilities, inpatient facilities, etc.), have a need that can be met by allowable program services defined in the statement of work, not currently receiving funding or services considered duplicative to Inspire’s authorized funding/services.

Accessible Child Care Training Supports (ACCTS) Program Overview

A thriving child-care workforce is essential to ensuring Harris County residents have access to high-quality early learning opportunities. The Harris County Accessible Child Care Training Supports (ACCTS) Program invests directly in the County’s child-care workforce by providing highly incentivized training and education opportunities that promote career advancement and wage growth.

The ACCTS Program supports child-care workers through three core strategies designed to strengthen their skills and improve long-term workforce retention:

  • Incentivized CDA Credential – Participants receive financial support to obtain their Child Development Associate (CDA) credential, a nationally recognized certification that can increase earning potential.
  • Incentivized High-Quality Training – Offers stipends and incentives for completing high-quality training courses aligned with Texas Rising Star standards and child development best practices.
  • Scholarships for Specialized Certifications – Provides scholarships for specialized certifications that equip workers with advanced skills in early learning and classroom management.

The program aims to attract new workers to the child-care sector, retain existing staff, and provide professional pathways for child-care educators to achieve higher wages and improved job satisfaction.

The Behavioral Health Substance Abuse Treatment and Overdose Prevention program is administered by four subrecipients:

  • Cenikor Foundation is expanding access to Medication-Assisted Treatment MAT services, peer recovery support, and recovery housing.
  • The Council on Recovery provides Outreach, Screening, Assessment, and Referral (OSAR) services, as well as training on overdose prevention and the use of naloxone.
  • Houston Recovery Center provides care coordination services increasing access to treatment and recovery housing, substance use prevention education, facilitates community-based support groups, and naloxone distribution and education.
  • Santa Maria Hostel, in partnership with Baylor College of Medicine, implements the I-CARE Clinic to expand access to physical healthcare, psychiatric care, and substance use disorder (SUD) treatment utilizing an integrated care approach.

COMMUNITY ENGAGEMENT

The Council on Recovery, Santa Maria Hostel, Houston Recovery Center, and Cenikor Foundation outreach strategies aim to reach individuals needing substance use disorder (SUD) services through:

  • Targeted outreach at community centers, assistance ministries, shelters, judicial partners, and specialty court sites
  • Program websites, social media campaigns, and digital promotions
  • Participation in community events and collaboration with local partners and organizations
  • Media coverage in local radio stations, news, and others

TARGET IMPACT

Target Goals Include:

  • Increase the number of people accessing SUD treatment
  • Increase the number of individuals trained on overdose prevention and use of naloxone
  • Connect individuals to recovery housing
  • Increase number of care coordination connections

USE OF EVIDENCE & PROGRAM EVALUATIONS

Since the COVID-19 pandemic, SUD-related deaths in Harris County have increased across four categories: alcohol, fentanyl, cocaine, and methamphetamines. Harris County has higher drug and opioid-involved overdose deaths than the Texas average and the highest rates of drug arrests and prosecutions in the state. Additionally, gaps in care services highlight the need for prevention services and connecting residents to available services.

PHOTOS