In California, wildfires, heatwaves, and other climate-driven disasters are creating unprecedented challenges to human health and well-being—particularly for communities that experience health inequities. California’s local health departments (LHDs) have an essential leadership role to play in our new era of climate-related emergencies. However, as our findings show, while LHD leaders across California see an urgent need for public health departments to engage in climate action to safeguard those most at risk, these departments do not receive adequate resources to address this public health crisis. This report, developed in partnership with the Public Health Alliance of Southern California, shows the way forward to ensure LHDs can foster a more equitable, healthy, and resilient California.