County Countdown – Nov. 20, 2023
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Every other week, NACo’s County Countdown reviews top federal policy advocacy items with an eye towards counties and the intergovernmental partnership.
Watch the video above and explore NACo resources below on some of the top issues we're covering this week.
1. Mental Health
NACo continues to champion mental health policies in Congress to support counties and residents.
- Continuity of care: A recent letter to leaders on Capitol Hill reiterated county priorities in mental health, including urging passage of the Due Process Continuity of Care Act, advocating for Medicaid benefits for pre-trial detainees.
- Workforce development: The letter also pushed for increased funding for programs to recruit and retain behavioral health workers.
- What’s next: NACo’s Commission on Mental Health and Wellbeing is working with Congress to reform mental health policies that exclude vulnerable populations.
2. Operation Green Light
Thank you to the hundreds of counties, plus our intergovernmental partners, businesses and individuals, who participated in Operation Green Light for Veterans.
- Bipartisan support: Congressional resolutions in both the House and Senate recognized Operation Greenlight and the vital role of County Veterans Services Officers (CVSOs).
- CVSO Act: In 29 states, county-funded CVSOs help veterans access over $50B annually in VA benefits. NACo urges the passage of the CVSO Act to secure federal resources to support this work.
- Explore highlights: Check out the Operation Green Light showcase for pictures submitted by counties – and submit yours!
3. Bipartisan Infrastructure Law
As we mark the two-year anniversary of the Bipartisan Infrastructure Law (BIL), NACo is ensuring that counties have a voice in its implementation.
- County guidance: Explore NACo’s BIL tools and best practices.
- Funding opportunities: Check out this tool for identifying current BIL funding opportunities.
4. Support for Rural America
U.S. Senators Bob Casey (D-Pa.) and Deb Fischer (R-Neb.) introduced the Rural Partnership and Prosperity Act.
- Addressing community needs: The bill would create a grant program to address needs like affordable child care, housing and job training, as well as providing guidance to help rural communities navigate existing funding opportunities.
- NACo's endorsement: NACo urges swift passage of this legislation, which will enable rural counties to optimize federal resources.
5. American Rescue Plan
The U.S. Treasury Department introduced a new rule clarifying counties' use of American Rescue Plan Act (ARPA) funds, further extending the reach of these resources.
Key points for counties: Counties can now allocate funds for administrative costs tied to ARPA reporting and compliance.
Clarifying responsibilities: Details on managing sub-recipient obligations offer counties more flexibility for effective resource utilization.
Dive deeper on ARPA: Explore all of NACo’s ARPA resources here.
NACo Commission on Mental Health and Wellbeing
(2023-2024) Counties increasingly handle direct mental health service. NACo’s Commission on Mental Health and Wellbeing developed reports and united county leaders to address the mental health crisis through key policy priorities.
Highlights from 2023 Operation Green Light for Veterans
Counties across the country joined 2023 Operation Green Light for Veterans to shine a light on the issues veterans face and highlight the resources available to veterans at the county, state and federal levels.
Implementing Infrastructure Investments at the County Level: The Bipartisan Infrastructure Law (P.L. 117-58)
The Bipartisan Infrastructure Law is a major victory for counties, who worked closely with our partners in Congress throughout the legislative process to ensure county priorities were included. NACo's implementation tracker highlights the latest information critical for counties.
Senators introduce bipartisan legislation to level playing field for rural communities
Senators introduced the Rural Partnership and Prosperity Act, bipartisan legislation intended to advance economic development in rural counties and overcome barriers to obtaining federal funding and resources.
U.S. House passes rescissions package
On June 12, the U.S. House of Representatives passed the Rescissions Act of 2025 (H.R. 4) in a narrow 214-212 vote. The legislation would cancel $9.4 billion in previously approved federal funding, marking the Trump Administration’s first formal attempt to codify funding cuts proposed by the Department of Government Efficiency (DOGE).
NACo releases new SALT deduction data for 2022 showing why relief is necessary
On June 11, NACo released profiles of the State and Local Tax deduction, illustrating the percentage of tax returns in a county with itemized deductions in 2022.
Arkansas county expands its future by preserving a 19th-century bridge
Saline County, Ark. is restoring a 134-year-old bridge connecting a 65-mile pedestrian and bike trail spanning from Little Rock to Hot Springs.
U.S. House reintroduces legislation to address the Medicaid Inmate Exclusion Policy with NACo support
Two bipartisan bills aimed at addressing the Medicaid Inmate Exclusion Policy (MIEP) were recently reintroduced in the U.S. House of Representatives.
U.S. House of Representatives re-establishes Bipartisan Mental Health Caucus with NACo support
On May 7, members of the U.S. House of Representatives appointed new leadership to the Bipartisan Mental Health Caucus, reaffirming their commitment to addressing the nation’s mental health crisis through cross-party collaboration.
House passes SUPPORT Act reauthorization
On June 4, the U.S. House of Representatives passed the SUPPORT for Patients and Communities Reauthorization Act of 2025 (H.R. 2483) by a strong bipartisan vote of 366–57. The bill, which reauthorizes billions of dollars for critical programs that target overdose prevention, now heads to the Senate Committee on Health, Education, Labor and Pensions, where a version of the bill was overwhelmingly advanced with bipartisan support in the 118th Congress.
Legislative Landscape: Prescription Drug Costs & County Impacts
Curious about Pharmacy Benefit Managers (PBM) and how they impact your county’s pharmacy benefits? This webinar from NACo's Public Promise Insurance breaks down what PBMs do, why they matter to counties, and how new legislation may reshape the cost and delivery of prescription drugs.
Conference
2024 NACo Legislative Conference
The NACo Legislative Conference brings together nearly 2,000 elected and appointed county officials to focus on federal policy issues that impact counties and our residents.
