Harris County officials on Feb. 26 moved forward with the second round of bond funding from a $2.5 billion Harris Health referendum that voters approved in 2023.
The bond dollars will fund a range of capital improvement projects within the Harris Health system, Harris County’s hospital district, including expansion of the Lyndon B. Johnson and Ben Taub hospitals, the latter of which has received backlash from some county residents in the last several months.
The big picture
Harris Health officials presented a first-quarter update to Harris County commissioners Feb. 26, outlining the system’s strategic facilities plan for the bond projects. The plan includes dozens of individual construction projects related to three core areas, as communicated to voters in 2023:
- Ambulatory care services, including new community clinics in Precincts 2, 3 and 4
- Ben Taub Hospital expansion
- Lyndon B. Johnson Hospital expansion
Harris Health received the first installment of bond funding totaling $850 million in May 2025. Chief Operating Officer Louis Smith told commissioners the system has spent approximately $667 million of that funding as of December.
The projects in total are projected to cost around $2.9 billion—almost half a billion more than the approved referendum—but Harris Health will use other funding sources, including philanthropy and cash on hand, to cover the difference, Smith said.
Latest update
During their Feb. 26 meeting, commissioners authorized a go-forward order to issue a second $850 million installment from the $2.5 billion referendum. Chief Financial Officer Victoria Nikitin said Harris Health is expecting to receive the funding by June.
She said the district’s construction projects are moving quickly, with an average spend of at least $80 million per month.
Construction of the 12-story John M. O’Quinn Hospital on LBJ’s campus, which broke ground in May 2024, makes up the largest portion of the capital project expenditures, per the presentation. Once completed, the Level 1 trauma-capable hospital will have doubled bed capacity, a helipad and a comprehensive stroke center, Community Impact previously reported.
The district is on track to complete the hospital’s new $50 million parking garage by the first quarter of 2027 and a $153 million central utility plant later that year, according to a breakdown of the construction projects.
Smith said the LBJ expansion cost has exceeded initial estimates made in 2021 and 2022, but Harris Health budgeted above those estimates and expects to remain within budget for the duration of the project.
The entire LBJ project is scheduled to be completed by the first quarter of 2029, he said.
A quick note
Approximately $157 million from the bond referendum is slated to fund the Ben Taub Hospital expansion at the Texas Medical Center, a $410 million project that would increase the facility’s operational capacity by 100 patient rooms.
However, the project is currently pending while the district awaits a March 19 public hearing regarding a controversial plan to acquire local parkland for the expansion.
Harris Health would have to acquire nearly 9 acres of Hermann Park to construct the new tower, which some residents have condemned in community town halls, Community Impact previously reported.
Harris County commissioners are expected to vote on the matter following the March hearing. Smith said if approved, he expects Harris Health would be prepared to break ground on the Ben Taub project by late 2027.
Looking forward
Smith said Harris Health will give quarterly updates to Harris County commissioners regarding the status of bond-related projects and dollars spent. Officials are scheduled to present the next update in May.
