Committee hears how Georgia public health is organized and funded — districts, grants, EMR rollout and budget pressures

State and local public‑health officials briefed a Georgia House study committee on how county health departments are organized and how DPH allocates state and federal funds, and they described operational differences between urban and rural counties.

Chris Ruston, interim district health director for Fulton County, and Will Bell, chief financial officer for the Georgia Department of Public Health, gave detailed descriptions of districts, staffing and DPH’s FY26 appropriation and county grant flows.

Structure and service delivery

Georgia’s public‑health system is a hybrid: oversight and technical assistance come from the state Department of Public Health while a county board of health in each of the state’s 159 counties sets local policy and approves local budgets. The state is organized into 18 public‑health districts; some districts are a single populous county (for example, Fulton) while others cover many rural counties.

District directors serve as the operational link between state and local boards: they are appointed by the DPH commissioner, vetted by county boards of health and act as chief executive for district governance. Local county health departments provide direct services — immunizations, WIC, family planning, STD/HIV testing and treatment, environmental health inspections, newborn and children’s screening programs — but the mix and frequency of services varies by county size and staff availability.

“District staff provide economies of scale — IT, HR and finance functions —…